Trifluoperazine
CLINICAL USE
Schizophrenia and other psychoses Anxiety Severe nausea and vomiting
DOSE IN NORMAL RENAL FUNCTION
Schizophrenia: initially 5 mg twice daily, increased by 5 mg after 1 week, then at intervals of 3 days according to response Anxiolytic and anti-emetic: 2–4 mg daily in divided doses; maximum 6 mg
PHARMACOKINETICS
Molecular weight : 407.5 %Protein binding : >99 %Excreted unchanged in urine : <1 Volume of distribution (L/kg) : 160 half-life – normal/ESRD (hrs) : 22/– DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50 : Dose as in normal renal function. Start with low dose 10 to 20 : Dose as in normal renal function. Start with low dose <10 : Dose as in normal renal function. Start with low dose 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 : Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min 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, e.g. procainamide, disopyramide and amiodarone – avoid concomitant use with amiodarone Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin – avoid concomitant use Antidepressants: increased level of tricyclics; possibly increased risk of antimuscarinic side effects Anti-epileptics: antagonism (convulsive threshold lowered) Antimalarials: avoid concomitant use with artemether/lumefantrine Antipsychotics: increased risk of ventricular arrhythmias with pimozide – avoid concomitant use Antivirals: concentration possibly increased with ritonavir Anxiolytics and hypnotics: increased sedative effects Beta-blockers: enhanced hypotensive effect; increased risk of ventricular arrhythmias with sotalol Diuretics: enhanced hypotensive effect Lithium: increased risk of extrapyramidal side effects and possibly neurotoxicity Pentamidine: increased risk of ventricular arrhythmias Sibutramine: increased risk of CNS toxicity – avoid concomitant use ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
– Comments
– OTHER INFORMATION
Reduce starting dose in elderly or frail patients by at least half .
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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