FLUPHENAZINE DECONATE

Indications & Dose:

Maintenance in schizophrenia and other psychoses

•  BY DEEP INTRAMUSCULAR INJECTION

Adult: Test dose 12.5 mg, dose to be administered into the gluteal muscle, then 12.5–100 mg after 4–7 days, then 12.5–100 mg every 14–35 days, adjusted according to response

Elderly: Test dose 6.25 mg, dose to be administered into the gluteal muscle, then 12.5–100 mg after 4–7 days, then 12.5–100 mg every 14–35 days, 

Contraindications:

Liver damage, cerebral arteriosclerosis, CAD, severe hypertension/ hypotension, blood dyscrasias, coma, subcortical brain damage, bone marrow depression. 

Side Effects:

Cautions:

Precautions:

Depression, acute pulmonary infection, chronic respiratory disorders, cardiovascular disease, glaucoma, seizure disorder; impaired hepatic/renal function; elderly, children < 12 yr, alcohol withdrawal, electroconvulsive therapy 

Interaction:

Drugs

Anticholinergics: Inhibition of therapeutic response to neuroleptics, additive anticholinergic effects

Antimalarial (amodiaquine, chloroquine, sulfadoxine pyrimethamine) Increased neuroleptic concentrations

Barbiturates: Reduced serum neuroleptic concentrations

Beta-blockers: Potential increases in serum concentrations of both drugs

Bromocriptine: Reduced effects of both drugs

Clonidine: Acute organic brain syndrome

Cyclic antidepressants: Increased serum concentrations of both drugs

Epinephrine: Reversal of pressor response to epinephrine

Guanadrel: Inhibits antihypertensive response

Levodopa: Inhibition of the antiparkinsonian effect of levodopa

Lithium: Rare cases of severe neurotoxicity have been reported in acute manic patients

Meperidine: Hypotension, excessive CNS depression

Orphenadrine: Reduced serum neuroleptic concentrations

Warnings:

Adverse Effects:

Lactations:

EPS in the newborn have been attributed to in utero exposure; other reports have indicated that phenothiazines

are relatively safe during pregnancy; excretion into breast milk unknown; use caution in nursing mothers 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Drowsiness, EPS: pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia; fatigue, headache, insomnia, neuroleptic malignant syndrome, seizures, vertigo

CV: Cardiac arrest, ECG changes, hypertension, orthostatic hypotension, tachycardia

EENT: Blurred vision, dry eyes, glaucoma

GI: Anorexia, constipation, diarrhea, dry mouth, hepatitis, jaundice, nausea, paralytic ileus, vomiting, weight gain

GU: Bladder paralysis, ejaculation inhibition, enuresis, male impotence, polyuria, priapism, urinary retention, frequency or incontinence

HEME: Agranulocytosis, anemia, aplastic anemia, hemolytic anemia, leukocytosis, leukopenia, thrombocytopenia

METAB: Amenorrhea, elevated prolactin levels, galactorrhea, hyperglycemia or hypoglycemia, hyponatremia, lactation, menstrual irregularities. Moderate breast engorgement (females), SIADH

RESP: Bronchospasm, dyspnea, laryngospasm

SKIN: Dermatitis, photosensitivity, rash

MISC: Heat intolerance

Patient And Carer Advice: