Zuclopenthixol
CLINICAL USE
Antipsychotic for schizophrenia and other psychoses
DOSE IN NORMAL RENAL FUNCTION
Schizophrenia and paranoid psychoses: Oral: 20–30 mg daily in divided doses; maximum 150 mg daily Maintenance:
20 to 50 : mg daily Deep IM: 200–500 mg every 1–4 weeks Maximum: 600 mg weekly Acute psychoses: (Clopixol Acuphase) Deep IM: 50–150 mg, repeated if required after 2–3 days Maximum 400 mg per course PHARMACOKINETICS
Molecular weight : 401 (443 as acetate), (473.9 as hydrochloride), (555.2 as decanoate) %Protein binding : 98 %Excreted unchanged in urine : Minimal ( 10 to 20 % unchanged drug and metabolites)
Volume of distribution (L/kg) : 10 to 20 : half-life – normal/ESRD (hrs) : 20–24 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 50% 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 Anaesthetics: enhanced hypotensive effects 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 Antidepressants: increased 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 ritonavir Anxiolytics and hypnotics: increased sedative effects Sibutramine: increased risk of CNS toxicity – avoid concomitant use Avoid concomitant use with drugs that prolong the QT interval ADMINISTRATION
Reconstition
– Route
Oral, IM Rate of Administration
– Comments
– OTHER INFORMATION
May cause hypotension and excessive sedation Increased CNS sensitivity in renally impaired patients – start with small doses as can accumulate Peak levels occur 3–6 hours after oral administration .the liver. It can be used in renal failure at normal doses with caution.
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
Home
