Fluphenazine Decanoate

Indications

Fluphenazine Decanoate is used for: In the long-term management of psychotic disorders including, Schizophrenia, Mania, Organic brain syndrome

Adult Dose

Intramuscular Psychoses; Mania; Schizophrenia Adult: As decanoate: Initially, 12.5 mg adjusted according to response. Maintenance: 12.5-100 mg at intervals of 2-6 wk. For doses >50 mg, increments should be made slowly in steps of 12.5 mg. Elderly: 6.25 mg adjusted according to response. Hepatic impairment: Use with caution; monitor

Child Dose

Safety and efficacy not established

Renal Dose

Renal impairment: Use with caution; monitor

Administration

Contra Indications

Fluphenazine Decanoate oily Injection is contraindicated in patients with hypersensitivity to the drug. Also contraindicated in comatose or severely depressed states, blood dyscrasias, liver disease, pregnancy (3rd trimester), lactation.

Precautions

Special precaution should be practiced in presence of convulsive disorders; hepatic, renal, cerebrovascular, respiratory and cardiovascular diseases. Also precaution should be observed in case of phenochromocytoma; bone marrow suppression; elderly or debilitated patients. Lactation: Drug enters breast milk; not recommended

Pregnancy-Lactation

Interactions

Reduces antihypertensive effects of guanethidine, methyldopa and clonidine. Lithium toxicity. Reduced bioavailability with antacids. Increased risk of arrhythmia when used with drugs that prolong QT interval. May cause electrolyte disturbance when used with diuretics. Potentially Fatal: Additive CNS depressant effects with alcohol, barbiturates, hypnotics, sedatives, opiates and antihistamines.

Adverse Effects

Side effects of Fluphenazine Decanoate : Frequency Not Defined Confusion, Decreased gag reflex Extrapyramidal symptoms Akathisia, Dystonia, Dyskinesia, Muscle stiffness, Neuroleptic malignant syndrome (NMS; infrequent but serious), Parkinsonism, Tardive dyskinesia Common Anticholinergic effects, Sedation, Weight gain, Erectile dysfunction, Oligomenorrhea or amenorrhea, Less common Orthostatic hypotension (after IM injection), tachycardia, Agitation, anxiety, cerebral edema, depression, dizziness, euphoria, headache, poikilothermia, restlessness, weakness, Anorexia, constipation, dyspepsia, ileus, Lens opacities (with prolonged use) Uncommon ECG changes, Photosensitivity, Pruritus, Diarrhea, Blood dyscrasia, Galactorrhea, Ejaculatory disorder Rare Seizure, Priapism, Cholestatic jaundice

Mechanism of Action

Fluphenazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It reduces aggressiveness with disappearance of hallucinations and delusions.