fluphenazine PROLIXIN

Class: First Generation Antipsychotic/​Phenothiazine
FDA Indications: Psychotic Disorders
Off-Label Use: Bipolar Disorder
Prescribing
Forms: 2.5, 5, 10mg tablet; 5mg/mL po soln; 2.5mg/mL IM; LAI: 125mg/5ml
Dose Range: 0.5-40 mg/day
Starting: 0.5-10 mg daily in divided doses (q6-8), can titrate up to 40 mg total daily dose
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis
Monitoring:

NAMI drug fact sheet

Precautions
Contraindications: In patients with suspected or established subcortical brain damage, in patients receiving large doses of hypnotics, and in comatose or severely depressed states
Serious Side Effects: , , , Cardiac Arrhythmias, Neutropenia and/or Agranulocytosis (rare), Hyperprolactinemia
Side Effects: sedation/somnolence, dizziness, weight gain, xerostomia, akathisia, sexual dysfunction, anticholinergic side effects, EPS, Neuroleptic-Induced Deficit Syndrome, priapism, galactorrhea, amenorrhea, hypotension
Pharmacodynamics
1° MOA: Dopamine 2 (D2) Receptor Antagonism In Mesolimbic Area
Target: D1 (high), D2 (very high), 5HT2 (very high), α1 (high), H1 (high), M1 (low)
Pharmacokinetics
t½: 18 (14-24)° TMAX: 2-6°
Substrate of: 2D6; 1A2
Inhibits: 2D6, 1A2; Induces:
Active Metabolites:
DDIs
Misc
  • - high potency typical antipsychotic
  • - fluphenazine enanthate was the first depot agent introduced in 1964
Special Populations

Category C—Third-trimester use can result in EPS or withdrawal symptoms in the newborn. Although one case report described multiple anomalies, most evidence suggests that phenothiazines are relatively low risk during pregnancy

No Human Data–Potential Toxicity


Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.

No dosage adjustment necessary.


No dosage adjustment necessary

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Last updated July 08 2018 15:58:23. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.