Trifluoperazine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Psychoses 2-5 mg twice daily, up to 15-20 mg/day. Severe or resistant: 40 mg/day. Nausea and vomiting; Short-term management of anxiety 1-2 mg twice daily. Max: 6 mg/day. For anxiety: Max duration: 12 wk. IM Acute psychosis 1-2 mg,repeat 4-6 hrly if needed. Max: 6 mg/day.
Dosage Details
Intramuscular
Acute psychosis
Adult: 1-2 mg by deep IM, repeated if necessary every 4-6 hr. Max: 6 mg daily.
Child: 1 mg by deep IM once or twice daily.
Elderly: Initiate at lower dose and increase gradually.

Oral
Psychoses
Adult: 2-5 mg bid gradually increased to 15-20 mg daily, or 40 mg daily in severe or resistant psychoses.
Child: Max: 5 mg daily in divided doses adjusted according to age, body weight and response.
Elderly: Initiate at lower dose and increase gradually.

Oral
Nausea and vomiting
Adult: 1-2 mg bid. Max 6 mg daily.
Child: 3-5 yrs: max 1 mg daily in divided doses; 6-12 yrs: max 4 mg daily.
Elderly: Initiate at lower dose and increase gradually.

Oral
Short-term management of anxiety
Adult: 1-2 mg bid. Max: 6 mg daily. Max duration: 12 wk.
Child: 3-5 yr: max 1 mg daily in divided doses; 6-12 yr: max 4 mg daily in divided doses.
Elderly: Initiate at lower dose and increase gradually.
Administration
Should be taken with food. May be taken w/ food to decrease GI upset; do not take w/in 2 hr of antacids.
Contraindications
Preexisting CNS depression and coma; bone marrow depression, blood dyscrasias, liver disease, hypersensitivity to phenothiazines, prolactin dependent tumours. Pregnancy (1st trimester), lactation.
Special Precautions
Cardiovascular disease, epilepsy, angle-closure glaucoma, exposure to extreme temperatures, elderly, parkinson's disease, myasthenia gravis, benign prostatic hyperplasia, DM, renal amd hepatic impairment. Discontinue trifluoperazine at least 48 hr before myelography and do not resume for at least 24 hr after procedure. Do not use trifluoperazine in control of nausea and vomiting occurring either prior to myelography or postprocedure with metrizamide. Pregnancy.
Adverse Reactions
Drowsiness, dry mouth, blurred vision, dizziness, sedation, antimuscarinic affects, postural hypotension, akathisia, muscle weakness, anorexia, insomnia, rash, amenorrhoea, fatigue, increased prolactin levels, extrapyramidal side effects.
Potentially Fatal: Neuroleptic malignant syndrome, blood dyscrasias.
Overdosage
Symptoms: extrapyramidal side effects, CNS depression, somnolence, agitation, restlessness, convulsions, ECG changes, cardiac arrhythmias, fever, autonomic reactions such as hypotension, dry mouth and ileus. Management: Treatment is symptomatic and supportive. Maintain an open airway as dysphagia and respiratory difficulty may occur in severe overdosage. Gastric lavage may be performed. Do not induce emesis as dystonic reaction of the head or neck may develop and this may lead to aspiration of vomitus. Extrapyramidal symptoms may be treated with anti-parkinsonism drugs, barbiturates, or diphenhydramine hydrochloride. If pressor agents are required, norepinephrine bitartrate and phenylephrine HCl may be used but not epinephrine. This is because trifluoperazine may reverse the usual elevating action of these agents and cause a further drop in blood pressure. Haemodialysis is not likely to be useful.
Drug Interactions
Increased CNS depression with CNS depressants such as opiates or other analgesics, barbiturates or other sedatives, general anaesthetics, or alcohol. Increased risk of side effects with drugs with antimuscarinic properties e.g. TCA, antiparkinsonian drugs. Antagonised effects of dopaminergic drugs such as levodopa. Increased risk of hypotension with antihypertensives, trazodone. Reverses antihypertensive effect of guanethidine. Increased risk of severe extrapyramidal side-effects or severe neurotoxicity with lithium. Possible decrease in absorption with antacids.
Action
Description: Trifluoperazine inhibits dopamine D2 receptors in the brain. It has weak anticholinergic and sedative effects but strong extrapyramidal and antiemetic effects. It controls severely disturbed, agitated or violent behaviour but may also be used for nonpsychotic anxiety.
Pharmacokinetics:
Absorption: Readily absorbed from GI tract. Peak plasma concentrations: 1.5-6 hr. Bioavailability: subject to interindividual variation.
Distribution: Protein binding: highly bound. Distributed into breast milk.
Excretion: Terminal half life: 22 hr.
Storage
Oral:
Psychoses: Store at 15-30°C
Nausea and vomiting: Store at 15-30°C.
Short-term management of anxiety: Store at 15-30°C.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Trifluoperazine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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