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Flupentixol information from DrugsUpdate  

See Available Brands of Flupentixol in India

P - Caution when used during pregnancy
L - Contraindicated in lactation

Flupentixol or flupenthixol, marketed as Depixol and Fluanxol, is a typical antipsychotic drug. It is a thioxanthene, and therefore closely related to the phenothiazines. This drug combines a piperazine moiety with the chemical thioxanthene which has been modified with the addition one carbon and three fluorine atoms.

Its main use is as a long acting injection given two or three weekly to people with schizophrenia who have a poor compliance with medication and suffer frequent relapses of illness. In some countries this can be involuntary under Community Treatment Orders.

Pharmacodynamics

Pharmacokinetics

Flupentixol is a thioxanthene antipsychotic that inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS.

Onset
24-72 hours (IM).

Duration

2-4 weeks (IM).

Absorption
Readily absorbed from the GI tract, peak plasma concentrations after 3-8 hours (oral); slowly absorbed from the inj site, peak plasma concentrations after 4-7 days (IM).

Distribution
Crosses the blood-brain barrier and placenta; enters breast milk. >95% bound to plasma proteins.

Metabolism
Extensively hepatic via sulfoxidation, side-chain N-dealkylation and glucuronic acid conjugation.

Excretion
Urine and faeces (as metabolites).

Flupentixol Indications / Flupentixol Uses

Information Not Available

Flupentixol Adverse Reactions / Flupentixol Side Effects

Rigidity, tremors, restlessness, tardive dyskinesia, insomnia, dryness of mouth, wt gain, sexual dysfunction, galactorrhoea and menstrual disturbances.

Potentially Fatal: Neuroleptic malignant syndrome (hyperthermia, hypertonicity of skeletal muscles, unconsciousness and autonomic nervous system instability).

Precautions

Information Not Available

Special Precautions

Patients with convulsive disorders; advanced hepatic, renal, CV or resp disease; tasks requiring mental alertness; elderly (especially with dementia), and debilitated patients; neuroleptics with sedative effect must be withdrawn gradually; history of angle-closure glaucoma; urinary retention; prostatic hyperplasia; breast cancer, prolactin dependent tumours; parkinsonism; myasthenia gravis; pregnancy; Avoid direct sunlight.

Other Drug Interactions

May potentiate the adverse effects of drugs with antimuscarinic effects e.g. TCAs. Reduced efficacy of levodopa. Increases adverse extrapyramidal symptoms with dopamine antagonists (metoclopramide and prochlorperazine).

Potentially Fatal: Potentiates CNS effects of alcohol, general anaesthetics, hypnotics, anxiolytics and opioids. Blocks antihypertensive effect of guanethidine.

Other Interactions

Information Not Available

Dosage

Oral
Psychoses
Adult: Initially, 3-9 mg bid, adjusted according to response. Max: 18 mg daily.
Elderly: Initial dose: ¼ or ½ of the usual initial dose.

Oral
Depression with or without anxiety
Adult: Initially, 1 mg daily increased after 1 wk to 2 mg daily and then to a max of 3 mg daily, last dose should be given not later than 4 p.m. Doses >2 mg should be given in 2 divided doses. Discontinue treatment if there is no improvement within 1 wk of using the max dose.
Elderly: Initially, 0.5 mg daily increased after 1 wk to 1 mg daily with the last dose given not later than 4 p.m. Max: 2 mg daily in 2 divided doses.
Max Dosage:

Intramuscular
Psychoses
Adult: As decanoate: Initially, 20 mg (1 ml of a 2% oily solution) is given as test dose. After at least 7 days and depending on the response, subsequent doses of 20-40 mg may be given at intervals of 2-4 wk. Usual maintenance dose: 50 mg every 4 wk to 300 mg every 2 wk. Up to 400 mg wkly may be used in severe or resistant cases.
Elderly: Initial dose: ¼ or ½ of the usual initial dose.

Food(before/after)

Information Not Available

List of Contraindications

Flupentixol and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Flupentixol and Lactation

Contraindicated in lactation

Flupentixol and Children

Information Not Available

Flupentixol and Geriatic

Information Not Available

Flupentixol and Other Contraindications

Hypersensitivity. Extremely excitable and overactive patients; mania; porphyria; coma; preexisting CNS depression; bone-marrow supression; phaeochromocytoma. Lactation.

Storage

Intramuscular
Store below 25°C.

Oral
Store below 25°C.

Lab interference

Intramuscular
Store below 25°C.

Oral
Store below 25°C.

Flupentixol brands in India:

Fluanxol Fluanxol Depot Flupen Pnxol

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