Molindone


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Schizophrenia
Adult: As hydrochloride: Initially, 50-75 mg daily in 3-4 divided doses; may be increased to 100 mg daily after 3 or 4 days. Maintenance: Mild symptoms: 5-15 mg 3-4 times daily. Moderately severe symptoms: 10-25 mg 3-4 times daily. Severe symptoms: Up to 225 mg daily. A single daily dose is often adequate for maintenance therapy. Patients with resistant mental and emotional disturbances may require wk or mth of treatment.
Elderly: and debilitated: Reduce dose.
Chống chỉ định
Coma, severe CNS depression.
Thận trọng
CNS depression. Parkinson's disease. Patients with haemodynamic instability; bone marrow suppression; predisposition to seizures; subcortical brain damage; severe cardiac, hepatic, renal, respiratory disease. Patients at risk of pneumonia. Breast cancer or other prolactin-dependent tumours. May alter temperature regulation or mask toxicity of other drugs. Patients at risk of orthostatic hypotension. Decreased GI motility, urinary retention, benign prostatic hyperplasia, xerostomia or visual problems. May impair ability to drive or operate machinery. Pregnancy and lactation.
Phản ứng phụ
Orthostatic hypotension, tachycardia, arrhythmia; extrapyramidal reactions, mental depression, altered central temperature regulation, sedation, drowsiness, restlessness, anxiety, hyperactivity, euphoria, seizure; pruritus, rash, photosensitivity; menstrual irregularities, oedema of breasts, galactorrhoea, gynaecomastia; constipation, xerostomia, nausea, salivation, wt gain/loss; urinary retention, priapism; leukopenia, leukocytosis; blurred vision, retinal pigmentation; decreased diaphoresis.
Potentially Fatal: Neuroleptic malignant syndrome (NMS).
Quá liều
Symptoms: Deep sleep, extrapyramidal symptoms, cardiac arrhythmias, seizures, hypotension. Management: Symptom-directed and supportive.
Tương tác
Increased risk of antipsychotic-related extrapyramidal symptoms with central acetylcholinesterase inhibitors, metoclopramide. Therapeutic response may be inhibited by anticholinergics (e.g. benztropine, trihexyphenidyl, biperiden, TCAs, antihistamines, disopyramide) and anticholinergic crisis may occur. May have additive hypotensive effects with antihypertensive agents, trazodone. May inhibit the effect of bromocriptine on prolactin levels. May cause additive sedation with barbiturates, benzodiazepines, opioid analgesics, ethanol. May produce neurotoxicity with lithium. Serum concentration may be increased with propranolol, sulfadoxine-pyrimethamine.
Potentially Fatal: Amphetamines may increase psychotic symptoms; may reduce efficacy of amphetamines. May inhibit antiparkinsonian effect of levodopa.
Food Interaction
Additive CNS depression may occur with kava kava, gotu kola, valerian, St John's wort.
Tác dụng
Description: Molindone is a dihydroindoline antipsychotic with general properties similar to those of chlorpromazine.
Duration: 24-36 hr.
Pharmacokinetics:
Absorption: Readily absorbed after oral doses; peak concentrations of unchanged drug within about 1.5 hr.
Metabolism: Hepatic; rapidly and extensively metabolised.
Excretion: Via urine and faeces (mainly as metabolites and <2-3% as unchanged drug). Elimination half-life: 1.5 hr.
Bảo quản
Store at 25°C (77°F). Protect from light.
Phân loại MIMS
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