Adult: As pipotiazine palmitate: Initially, 25 mg as test dose followed by 25-50 mg after 4 to 7 days. Adjust in increments of 25-50 mg according to response every 4 wk. Maintenance: 50-100 mg every 4 wk. Max: 200 mg every 4 wk. Elderly: >50 yr Initially, 5-10 mg.
Comatose states, marked cerebral atherosclerosis, phaeochromocytoma, severe cardiac insufficiency. Renal or hepatic impairment.
Patient w/ or who have history of severe resp disease, epilepsy, alcohol withdrawal symptoms, brain damage, Parkinson’s disease or marked extrapyramidal symptoms w/ previously used neuroleptics, angle-closure glaucoma, hypothyroidism, myasthenia gravis, prostatic hypertrophy, thyrotoxicosis. Elderly. Pregnancy and lactation.
This drug may cause drowsiness, if affected, do not drive or operate machinery.
Monitor mental status, vital signs, wt, height, BMI, waist circumference, CBC, electrolytes, LFT, glucose level, menstrual cycle, erectile and ejaculatory function, development of galactorrhoea, parkinsonian signs, tardive dyskinesia, ECG and ocular examination.
Symptoms: Drowsiness, loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmias, hypothermia and severe extrapyramidal dyskinesia. Management: May administer inotropic agent such as dopamine to correct circulatory collapse. Restore normal body temp and correct circulation.
Increased risk of arrhythmias when concomitantly used w/ QT prolonging drugs (e.g. antiarrhythmics, antidepressants, other antipsychotics) and drugs causing electrolyte imbalance. Enhanced CNS depressant effect (e.g. resp depression) w/ barbiturates and other sedatives. Increased plasma concentration when used w/ ritonavir. Increased risk of extrapyramidal effects when used w/ tetrabenazine and lithium. Increased neurotoxicity w/ lithium. May increase the hypotensive effect of a α-adrenoceptor blocking agents. Decreased neuroleptic effect when used w/ anticholinergic agents.
Additive CNS depressant effect w/ alcohol.
May cause false-positive or negative pregnancy test.
Description: Pipotiazine antagonises postsynaptic mesolimbic dopaminergic receptors in the brain. It depresses the release of hypothalamic and hypophyseal hormones, hence it is less sedating, has less potential to potentiate other CNS depressants and may possess a lower propensity to cause hypotension. Onset: 2-3 days (IM). Duration: 3-6 wk. Pharmacokinetics: Absorption: Slowly absorbed from the site of inj (IM).