Periciazine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Anxiety; Agitation; Aggression; Impulsive behaviour Initial: 15-30 mg/day in 2 divided doses. Administer larger doses at bedtime. Schizophrenia; Psychoses Initial: 75 mg/day in divided doses, then increase dose by 25 mg/day at weekly intervals until optimum effect is achieved. Max: 300 mg/day.
Dosage Details
Oral
Psychoses, Schizophrenia
Adult: Initially, 75 mg daily in divided doses, then increase doses by 25 mg daily at weekly intervals until optimum effect is achieved. Max: 300 mg daily.
Child: ≥1 year weighing 10 kg: Initially, 500 mcg, increase by 1 mg for each additional 5 kg of body weight. Max: 10 mg daily. Dose may be increased gradually according to response. Maintenance dose should not exceed twice the initial dose; ≥12 years Same as adult dose.
Elderly: Initially, 15-30 mg daily in divided doses. May increase dose if necessary according to patient tolerability.

Oral
Aggression, Anxiety, Impulsive behaviour, Psychomotor agitation
Adult: Initially, 15-30 mg daily in 2 divided doses. Administer larger doses at bedtime.
Elderly: Initially, 5-10 mg daily in divided doses. Administer larger doses at bedtime. Maintenance: Half or quarter of the adult dose.
Renal Impairment
Contraindicated.
Hepatic Impairment
Contraindicated.
Contraindications
Coma or altered states of consciousness due to CNS depressant intoxication, Parkinson’s disease, untreated seizure disorder, circulatory collapse, narrow-angle glaucoma, phaeochromocytoma, myasthenia gravis, hypothyroidism, prostate hypertrophy. Hepatic and renal impairment. Concomitant use with spinal or regional anaesthesia.
Special Precautions
Patient with epilepsy or history of seizures, cerebrovascular disease, severe CV disease, familial long QT syndrome, electrolyte imbalance (e.g. hypokalaemia, hypomagnesaemia), decreased gastrointestinal motility, paralytic ileus, urinary retention, xerostomia, other visual problems, risk factors for aspiration pneumonia (e.g. Alzheimer’s disease), Lewy body dementia, diabetes mellitus, head trauma, brain damage, alcoholism, hypovolaemia, risk factors for thrombosis, breast cancer or other prolactin-dependent tumours. Avoid abrupt withdrawal. Children. Elderly (including those with dementia-related psychosis). Pregnancy and lactation.
Adverse Reactions
Significant: Neuroleptic malignant syndrome, anticholinergic effects (e.g. constipation, xerostomia, blurred vision, urinary retention), altered cardiac conduction, QT prolongation, orthostatic hypotension, venous thromboembolism, blood dyscrasias (e.g. agranulocytosis, granulocytopenia, neutropenia), CNS depression, oesophageal dysmotility and aspiration, extrapyramidal symptoms, pseudoparkinsonism, acute dystonic reactions, akathisia, tardive dyskinesia, hyperprolactinaemia, fall; pigmentary retinopathy, corneal deposits, changes in skin pigmentation (prolonged use), impaired body temperature regulation, weight gain, glucose intolerance, hyperglycaemia, diabetic ketoacidosis, increased prolactin level.
Blood and lymphatic system disorders: Leucopenia.
Cardiac disorders: Atrioventricular block.
Gastrointestinal disorders: Dry mouth, nausea, constipation, diarrhoea, cholestasis. faecal impaction, increased appetite.
Hepatobiliary disorders: Jaundice, liver injury.
Immune system disorders: Angioedema.
Nervous system disorders: Insomnia, agitation, drowsiness, headache, dizziness.
Psychiatric disorders: Paradoxical psychosis.
Renal and urinary disorders: Urinary incontinence.
Reproductive system and breast disorders: Galactorrhoea, gynaecomastia, amenorrhoea, impotence, priapism.
Respiratory, thoracic and mediastinal disorders: Respiratory depression, nasal congestion, asthma, laryngeal oedema, pneumonia.
Skin and subcutaneous tissue disorders: Rashes, diaphoresis.
Vascular disorders: Deep vein thrombosis.
Potentially Fatal: Ventricular arrhythmia, pulmonary embolism.
Patient Counseling Information
This drug may cause drowsiness, if affected, do not drive or operate machinery. Avoid direct sunlight.
MonitoringParameters
Monitor CBC, vital signs, mental status, electrolytes, renal function, LFT, FBS, lipid profile, weight, height, BMI, and waist circumference. Monitor for changes in menstruation, libido, galactorrhoea; parkinsonian signs, tardive dyskinesia; visual changes.
Overdosage
Symptoms: CNS depression manifested as drowsiness or loss of consciousness, hypotension, tachycardia, ventricular arrhythmia, ECG changes, hypothermia; severe extra-pyramidal dyskinesias. Management: Supportive treatment. Perform gastric lavage within 6 hours of ingestion. May give activated charcoal. Maintain airways or allow assisted respiration in case of CNS depression. In cases of circulatory collapse, raise patient’s legs, volume expansion by IV fluids (severe cases), may administer inotropes (e.g. dopamine) if needed. In cases of hypotension, place patient in the head down position, and give IV norepinephrine or phenylephrine. Administer benztropine in cases of severe extrapyramidal reactions.
Drug Interactions
Increased risk of arrhythmias with QT prolonging drugs (e.g. antiarrhythmics, antidepressants, other antipsychotics). Enhanced therapeutic effect of antihypertensive agents (e.g. α-adrenoceptor blocking agents). Enhanced CNS depressant effect with barbiturates, benzodiazepines, and other sedatives. Diminished therapeutic efficacy of levodopa, clonidine, guanethidine, and adrenaline. Increased risk of agranulocytosis with carbamazepine. May increase plasma concentration of amitriptyline. Decreased absorption with antacids, anti-Parkinson drugs, or lithium. May increase or decrease the plasma concentrations of propranolol or phenobarbital.
Food Interaction
Increased CNS depressant effect with alcohol.
Lab Interference
May cause a false-positive pregnancy test.
Action
Description: Periciazine is a phenothiazine with a piperidine side chain which produces a more pronounced sedative action and weak antipsychotic properties. It blocks subcortical dopamine receptors in the brain and decreases the amount of hypothalamic and hypophyseal hormones.
Synonym: pericyazine
Chemical Structure

Chemical Structure Image
Periciazine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4747, Periciazine. https://pubchem.ncbi.nlm.nih.gov/compound/Periciazine. Accessed Oct. 26, 2020.

Storage
Store below 25°C. Protect from light.
MIMS Class
ATC Classification
N05AC01 - periciazine ; Belongs to the class of phenothiazine antipsychotics with piperidine structure.
References
Anon. Periciazine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/10/2020.

Buckingham R (ed). Pericyazine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/10/2020.

Joint Formulary Committee. Pericyazine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/10/2020.

Pericyazine 10 mg Tablets (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk/. Accessed 09/10/2020.

Pericyazine 10 mg/5 mL Syrup (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk/. Accessed 09/10/2020.

Sanofi-Aventis New Zealand Limited. Neulactil Tablets data sheet 04 December 2018. Medsafe. http://www.medsafe.govt.nz/. Accessed 09/10/2020.

Disclaimer: This information is independently developed by MIMS based on Periciazine 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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