HEALTHY LIFESTYLE




Flupentixol
Flupentixol.JPG

Flupentixol

CLINICAL USE

Antipsychotic:Schizophrenia and other psychoses Depression

DOSE IN NORMAL RENAL FUNCTION

Psychosis: Oral: 3–9 mg twice daily —Deep IM: 50 mg 4 weekly – 300 mg 2 —weekly; maximum dose 400 mg weekly; 20–40 mg every 2–4 weeks may be adequate in some patientsDepression: 0.5–3 mg daily (doses above 2 mg should be in 2 divided doses, and 2nd dose should not be after 4 pm)

PHARMACOKINETICS

  • Molecular weight                           :434.5 (588.8 as decanoate)
  • %Protein binding                           :>95
  • %Excreted unchanged in urine     : Negligible
  • Volume of distribution (L/kg)       :12–14
  • half-life – normal/ESRD (hrs)      :22–36 (IM: 3–8 days)/Increased

    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 quarter to half of the dose and titrate slowly

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Alcohol: enhanced effects
  • Anaesthetics: enhanced hypotensive effects
  • Analgesics: increased risk of convulsions with tramadol; enhanced hypotensive and sedative effects with opioids
  • Antidepressants: increased plasma level of tricyclics
  • Anti-epileptics: anticonvulsant effect antagonised
  • Antimalarials: avoid concomitant use with artemether/lumefantrine
  • Antipsychotics: avoid concomitant use of clozapine with depot preparations in case of neutropenia
  • Antivirals: concentration possibly increased with ritonavirAnxiolytics and hypnotics: increased sedative effects
  • Sibutramine: increased risk of CNS toxicity – avoid concomitant useAvoid concomitant use with drugs that prolong the QT interval

    ADMINISTRATION

    Reconstition

    Route

    Oral, IM

    Rate of Administration

    Comments

    OTHER INFORMATION

    May cause hypotension and sedation in renal impairmentIncreased CNS sensitivity in renally impaired patients – start with small doses as can accumulateFor IM injection a 20 mg test dose should first be givenOral bioavailability is 40–55% Peak levels occur 7 days after IM injection and 4 hours after oral administration.
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