CLINICAL USE

Antipsychotic

DOSE IN NORMAL RENAL FUNCTION

2–20 mg daily

PHARMACOKINETICS

  • Molecular weight                           :461.5
  • %Protein binding                           :99
  • %Excreted unchanged in urine     : <1
  • Volume of distribution (L/kg)       :No data
  • half-life – normal/ESRD (hrs)      :55–150/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Start with low dose and increase according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Unknown dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Anaesthetics: enhanced hypotensive effect
  • Analgesics: increased risk of convulsions with tramadol; enhanced hypotensive and sedative effects with opioids
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with anti-arrhythmics that prolong the QT interval – avoid concomitant use with amiodarone, disopyramide and procainamide (risk of ventricular arrhythmias)
  • Antibacterials: avoid concomitant use with macrolides and moxifloxacin (increased risk of ventricular arrhythmias)
  • Antidepressants: concentration increased by sertraline and possibly paroxetine – avoid with paroxetine; increased risk of ventricular arrhythmias with maprotiline and tricyclics – avoid concomitant use; increased plasma level of tricyclics
  • Anti-epileptics: antagonises anticonvulsant effect
  • Antifungals: avoid concomitant use with imidazoles and triazoles
  • Antimalarials: avoid concomitant use with artemether/lumefantrine; increased risk of ventricular arrhythmias with mefloquine and quinine – avoid concomitant use
  • Antipsychotics: increased risk of ventricular arrhythmias with phenothiazines – avoid concomitant use
  • Antivirals: concentration increased by amprenavir, atazanavir, efavirenz, indinavir, nelfinavir, ritonavir and saquinavir, increased risk of ventricular arrhythmias – avoid concomitant useAnxiolytics and hypnotics: increased sedative effectsAprepitant: avoid concomitant use
  • Atomoxetine: increased risk of ventricular arrhythmias
  • Beta-blockers: increased risk of ventricular arrhythmias with sotalol
  • Diuretics: increased risk of ventricular arrhythmias due to hypokalaemiaIvabradine: increased risk of ventricular arrhythmias
  • Sibutramine: increased risk of CNS toxicity – avoid concomitant use

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    ECG required before treatment. To be repeated annually.

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