Fluphenazine

Indications
 Oral
Psychoses
Adult: Initially, 2.5-10 mg daily in 2-3 divided doses, increased according to reponse. Maintenance: 1-5 mg daily.
Max Dosage: Adult: 20 mg/day. Elderly: 10 mg/day.
Oral
Mania
Adult: Initially, 2.5-10 mg daily in 2-3 divided doses, increased according to reponse. Maintenance: 1-5 mg daily.
Max Dosage: Adult: 20 mg/day. Elderly: 10 mg/day.
Oral
Schizophrenia
Adult: Initially, 2.5-10 mg daily in 2-3 divided doses, increased according to reponse. Maintenance: 1-5 mg daily.
Max Dosage: Adult: 20 mg/day. Elderly: 10 mg/day.
Oral
Short-term adjunct in severe anxiety or behavioral disturbances
Adult: 1 mg bid increased to 2 mg bid if necessary.
Intramuscular
Psychoses
Adult: As decanoate: Initially, 12.5 mg adjusted according to response. Maintenance: 12.5-100 mg at intervals of 2-6 wk. For doses >50 mg, increments should be made slowly in steps of 12.5 mg. The enantate ester can be given in similar doses at intervals of 1-3 wk.
Elderly: 6.25 mg adjusted according to response.
Intramuscular
Mania
Adult: As decanoate: Initially, 12.5 mg adjusted according to response. Maintenance: 12.5-100 mg at intervals of 2-6 wk. For doses >50 mg, increments should be made slowly in steps of 12.5 mg. The enantate ester can be given in similar doses at intervals of 1-3 wk.
Elderly: 6.25 mg adjusted according to response.
Intramuscular
Schizophrenia
Adult: As decanoate: Initially, 12.5 mg adjusted according to response. Maintenance: 12.5-100 mg at intervals of 2-6 wk. For doses >50 mg, increments should be made slowly in steps of 12.5 mg. The enantate ester can be given in similar doses at intervals of 1-3 wk.
Elderly: 6.25 mg adjusted according to response.
Contraindications
 Hypersensitivity; comatose or severely depressed states; blood dyscrasias; liver disease; bone marrow depression; phaeochromocytoma; suspected or established subcortical brain damage with or without hypothalamic damage; pregnancy (3rd trimester), lactation.
Warnings / Precautions
 Presence of convulsive disorders; hepatic, renal, cerebrovascular, resp and CV diseases; elderly or debilitated patients. May elevate prolactin levels which may persist after chronic admin. May exacerbate depression. Closed-angle glaucoma. History of jaundice, parkinsonism, DM, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia or urinary retention. Regular eye examinations in patients receiving long term therapy. Avoid direct sunlight exposure.
Adverse Reactions
 Tardive dyskinesia, sedation, mental confusion; hypotension; hyperprolactinaemia leading to galactorrhoea and amenorrhoea in women; loss of libido, impotence and sterility in males. Allergic reactions, cholestatic jaundice, corneal and lens deposits, skin pigmentation.
Potentially Fatal: Agranulocytosis; neuroleptic malignant syndrome.
Drug Interactions
 Reduces antihypertensive effects of guanethidine, methyldopa and clonidine. Lithium toxicity. Reduced bioavailability with antacids. Increased risk of arrhythmia when used with drugs that prolong QT interval. May cause electrolyte disturbance when used with diuretics.
Potentially Fatal: Additive CNS depressant effects with alcohol, barbiturates, hypnotics, sedatives, opiates and antihistamines.
See Below for More fluphenazine Drug Interactions
Mechanism of Actions
 Fluphenazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It reduces aggressiveness with disappearance of hallucinations and delusions.
Onset: 1-3 days.
Duration: 2-4 days.
Absorption: Absorbed as HCl from the GI tract (oral); slowly absorbed as decanoate and enantate (SC/IM).
Distribution: Crosses the placenta; enters breast milk. Protein-binding: 91-99%.
Metabolism: Hepatic.
Excretion: Urine (as metabolites); 14.7 hr (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Intramuscular: Store at 15-30°C. Oral: Store at 15-30°C.
ATC Classification
 N05AB02 - fluphenazine ; Belongs to the class of phenothiazine antipsychotics with piperazine structure.
Storage
 Intramuscular: Store at 15-30°C. Oral: Store at 15-30°C.
Available As
  • Fluphenazine 1 mg
  • Fluphenazine 25 mg

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