about Fluphenazine class, uses, side effects contraindications

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Fluphenazine

Short Description

Fluphenazine belongs to a group of medicines called phenothiazine antipsychotics.
These drugs are used to treat psychotic disorders, such as schizophrenia, and to relieve associated psychotic symptoms, such as hallucinations, delusions, and aggression.
This medication can be given by long-acting injection (Depot). This form of medication is particularly suitable for patients who do not remember to take the medication every day.

Pregnancy category: Not rated

Indications

To control psychotic disorders ELIXIR,,(FLUPHENAZINE HYDROCHLORIDE) Adults and adolescents.Initial: 2.5 to 10 mg/day in divided doses every 6 to 8 hr. When symptoms are controlled, dosage reduced to 1 to 5 mg daily. Maximum: 20 mg/dose with caution. Children. 250 to 750 mcg once daily to q.i.d.
I.M.INJECTION(FLUPHENAZINE HYDROCHLORIDE) Adults and adolescents. Initial: 1.25 mg, increased as clinical condition tolerates up to 2.5 to 10 mg daily in divided doses every 6 to 8 hr. Maximum: 10 mg daily.
DOSAGE ADJUSTMENT For elderly or debilitated patients, dosage reduced to 1 to 2.5 mg daily in divided doses every 6 to 8 hr. I.M.OR SUBCUTANEOUS INJECTION(FLUPHENAZINE DECANOATE OR ENANTHATE)
Adults.Initial: 12.5 to 25 mg every 1 to 4 wk, as needed (decanoate). For doses over 50 mg, next dose increased cautiously by 12.5 mg. Or 25 mg every 2 wk, with dose and dosing interval adjusted based on patient response (enanthate). Maximum: 100 mg/dose. fluphenazine 450 Adolescents and children age 12. Initial: 6.25 to 18.75 mg/wk (decanoate), increased to 12.5 to 25 mg every 1 to 3 wk, according to condition. Children ages 5 to 12. 3.125 to 12.5 mg every 1 to 3 wk (decanoate), according to condition. Route Onset Peak Duration P.O. In 1 hr Variable 6–8 hr I.M.* In 1 hr Variable 6–8 hr I.M., In 24– Variable 1–6 wk SubQ 72 hr

Mechanism of Action

May block postsynaptic dopamine receptor sites in the CNS. This action may depress areas of the brain that control activity and aggression, including the cerebral cortex, hypothalamus, and limbic system.

Incompatibilities

Don’t mix fluphenazine hydrochloride oral solution with beverages that contain caffeine, such as coffee and cola; tannins, such as tea; or pectins, such as apple juice. They’re physically incompatible.

Contraindications

Blood dyscrasias, bone marrow depression, cerebral arteriosclerosis, coma, concomitant use of large amounts of another CNS depressant, coronary artery disease, hepatic dysfunction, hypersensitivity to phenothiazines, myeloproliferative disorders, severe CNS depression, severe hypertension or hypotension, subcortical brain damage

Interactions

adsorbent antidiarrheals, aluminumor magnesium-containing antacids: Possibly inhibited absorption of fluphenazine amantadine, anticholinergics: Possibly intensified adverse effects of both amphetamines: Possibly decreased therapeutic effects of both antihypertensives: Possibly severe hypotension antithyroid : Increased risk of agranulocytosis
beta blockers: Possibly increased blood levels and risk of adverse effects of both bromocriptine: Decreased bromocriptine effects
CNS depressants: Possibly prolonged and intensified CNS depression erythromycin: Possibly inhibited fluphenazine metabolism guanethidine: Decreased hypotensive effect of guanethidine levodopa: Possibly decreased antidyskinetic effect of levodopa lithium: Possibly neurotoxicity (disorientation, extrapyramidal reactions, unconsciousness) meperidine: Excessive sedation and hypotension metrizamide: Increased risk of seizures when injected in subarachnoid area during fluphenazine therapy oral anticoagulants: Possibly decreased anticoagulant effects pimozide, other that prolong QT interval: Prolonged QT interval and risk of arrhythmias thiazide diuretics: Increased risk of hyponatremia, hypotension, and water intoxication tricyclic antidepressants: Possibly prolonged and intensified sedation
alcohol use: Possibly increased CNS depression and increased risk of heatstroke

Side Efect

CNS: Ataxia, cerebral edema, dizziness, drowsiness, headache, insomnia, lightheadedness, nervousness, seizures, slurred speech, syncope, worsening psychotic symptoms
CV: AV conduction disorders, bradycardia, cardiac arrest, hypercholesterolemia, hypertension, orthostatic hypotension, QT-interval prolongation, shock, ST-segment depression, tachycardia
EENT: Blurred vision, dry mouth, glaucoma, increased salivation, laryngeal edema, laryngospasm, miosis, mydriasis, nasal congestion, papillary hypertrophy of the tongue, parotid gland enlargement, photophobia, pigmentary retinopathy, ptosis
ENDO: Breast engorgement (females), galactorrhea, hyperglycemia, hypoglycemia, mastalgia, syndrome of inappropriate ADH secretion fluphenazine 451 E F * For hydrochloride. For decanoate and enanthate. For decanoate; 2 wk for enanthate.
GI: Anorexia, constipation, diarrhea, fecal impaction, ileus, increased appetite, nausea, vomiting
GU: Amenorrhea, bladder paralysis, decreased libido, enuresis, menstrual irregularities, polyuria, urinary frequency, urinary incontinence, urine retention
HEME: Anemia, aplastic anemia, eosinophilia, leukopenia, thrombocytopenia, thrombocytopenic or nonthrombocytopenic purpura
RESP: Bronchospasm, dyspnea, increased respiratory depth
SKIN: Contact dermatitis, dry skin, eczema, erythema, jaundice, photosensitivity, pruritus, seborrhea
Other: Heatstroke, hyponatremia, lupuslike symptoms, weight gain

Cautions

Fluphenazine shouldn’t be used to treat dementia-related psychosis in elderly patients because of an increased mortality risk.

Use fluphenazine cautiously in patients with a history of glaucoma or renal impairment.

For I.M. and subcutaneous injection, use at least a 21G needle.

Monitor temperature; a significant, unexplained rise can indicate intolerance and a need to discontinue drug. Notify prescriber immediately if this occurs.

Watch for signs of hepatic failure, such as jaundice.

Notify prescriber about worsening psychotic sympto
MS: agitation, catatonic state, confusion, depression, hallucinations, lethargy, paranoid reactions.

PATIENT SAFTY

If patient takes elixir form of fluphenazine, instruct her to keep it in an amber or opaque bottle because drug is sensitive to light.

Advise patient not to mix oral solution with beverages that contain caffeine (coffee, cola), tannins (tea), or pectins (apple juice).

Caution patient about possible dizziness or light-headedness.

Teach patient how to prevent heatstroke, orthostatic hypotension, and photosensitivity reactions.

Warn against stopping drug abruptly.

Trade Name & Company Name

Trade name	Company name
FLUPHENAZINE DECANOATE 25MG-ML INJECTION	ANTIGEN
FLUPHENAZINE DECANOATE OILY 100MG-ML AMP	HOSPIRA AUSTRALIA
FLUPHENAZINE DECANOATE OILY 25MG-ML AMP	HOSPIRA AUSTRALIA

effect of Fluphenazine in Pregnancy, Fetal Health and Breast feeding

Pregnancy

. Fluphenazine is a long-acting parenteral antipsychotic typically used in institutional settings. There are no adequate reports or well-controlled studies in pregnant women. Consistent with its biochemistry, fluphenazine increases maternal prolactin.

Fetal Health

There are no adequate reports or well-controlled studies in human fetuses. It is unknown whether fluphenazine crosses the human placenta. Rodent studies reveal bone and CNS malformations. The incidence of these malformations increases significantly when diphenylhydantoin is administered concurrently. Peroxidative bioactivation of phenothiazines to their 413 cation radical by human placental peroxidase may be one mechanism of developmental toxicity.

Breastfeeding

There is no published experience in nursing women. It is unknown whether fluphenazine enters human breast milk.

the follwing drugs will increse Fluphenazine by inhepiting cyp450

No File found

the follwing drugs will decrease Fluphenazine by inhancing cyp450