Systematic (IUPAC) name | |
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2-[4-[3-[2-(trifluoromethyl)-10H-phenothiazin-10-yl]propyl]piperazin-1-yl]ethanol
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Clinical data | |
Trade names | Prolixin, Modecate, Moditen others |
AHFS/Drugs.com | monograph |
MedlinePlus | a682172 |
Pregnancy category |
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Routes of administration |
Oral, IM, depot injection (fluphenazine decanoate) |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | 2.7% (Oral) |
Metabolism | unclear[1] |
Biological half-life | IM 15 hours (HCL), 7-10 days (decanoate)[1] |
Excretion | Urine, faeces |
Identifiers | |
CAS Number | 69-23-8 |
ATC code | N05AB02 (WHO) |
PubChem | CID 3372 |
IUPHAR/BPS | 204 |
DrugBank | DB00623 |
ChemSpider | 3255 |
UNII | S79426A41Z |
KEGG | D07977 |
ChEBI | CHEBI:5123 |
ChEMBL | CHEMBL726 |
Chemical data | |
Formula | C22H26F3N3OS |
Molar mass | 437.523 g/mol |
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Fluphenazine, sold under the brand names Prolixin among others, is a antipsychotic medication.[1] It is used in the treatment of chronic psychoses such as schizophrenia.[1] It is given by mouth, injection into a muscle, or just under the skin.[1] There is a long acting injectable version that may last for up to four weeks.[1]
Common side effects include movement problems, sleepiness, and increased weight. Serious side effects may include the potentially permanent movement disorder tardive dyskinesia, neuroleptic malignant syndrome, and low white blood cell levels. In older people with psychosis as a result of dementia it may increase the risk of dying. It may also increase prolactin levels which may result in milk production. It is unclear if it is safe for use in pregnancy. Fluphenazine is a typical antipsychotic of the phenothiazine class. Its mechanism of action is not entirely clear but believed to be related to its ability as a dopamine antagonist.[1]
Fluphenazine came into use in 1959.[2] It is on the World Health Organization's List of Essential Medicines, most important medication needed in a basic health system.[3] It is available as a generic medication.[1] In the United States the pills costs between 0.22 and 0.42 USD per day for a typical dose.[1] The wholesale cost of the long acting form is between 0.20 and 6.20 USD per injection as of 2014.[4]
Medical uses
Its primary uses is in the treatment of schizophrenia.[5] It appears to be about equal in effectiveness to low-potency antipsychotics.[6]
Side effects
- Common adverse effects (i.e. those that have an incidence ≥1%) include
- Hypotension
- Orthostatic hypotension
- Somnolence/ drowsiness
- Weight gain
- Erectile dysfunction
- Oligomenorrhea or amenorrhea
- Anticholinergic effects, such as:
- - Dry mouth
- - Constipation
- - Nasal congestion
- - Blurred vision
- - Diminished sweating
- Extrapyramidal side effects, such as:
- - Tremor
- - Akathisia
- - Muscle rigidity
- - Dystonia
- - Parkinsonism
- Dizziness
- Epithelial keratopathy
- Eye / vision finding
- Retinitis pigmentosa
- Photosensitivity
- Uncommon side effects (0.1%≤incidence<1%) include
- Agitation
- Anxiety
- Cerebral oedema
- Depression
- Euphoria
- Headache
- Ineffective temperature regulation
- Restlessness
- Weakness
- Weight loss
- Dyspepsia
- Lens opacities (with prolonged use)
- Photosensitivity
- Pruritus
- Diarrhoea
- Galactorrhoea
- Ejaculatory disorder
- QT interval prolongation
- Rare (incidence<0.1%) side effects include
- Blood dyscrasia (e.g. neutropaenia, agranulocytosis, leukopaenia, etc.)
- Seizures
- Paralytic ileus
- Torsades de Pointes
- Heatstroke
- Hypothermia
- Priapism
- Drug-induced Systemic lupus erythematosus
- Obstipation
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Cholestatic jaundice syndrome
- Unknown frequency side effects include
- Confusion
- Decreased gag reflex
- Silent pneumonia (likely rare)
References
- ^ a b c d e f g h i "fluphenazine decanoate". The American Society of Health-System Pharmacists. Retrieved Dec 1, 2015.
- ^ McPherson, Edwin M. (2007). Pharmaceutical Manufacturing Encyclopedia. (3rd ed.). Burlington: Elsevier. p. 1680. ISBN 9780815518563.
- ^ "WHO Model List of Essential Medicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
- ^ "Fluphenazine Decanoate". International Drug Price Indicator Guide. Retrieved 2 December 2015.
- ^ a b "PRODUCT INFORMATION MODECATE (Fluphenazine Decanoate Oily Injection)" (PDF). TGA eBusiness Services. Bristol-Myers Squibb Australia Pty Ltd. 1 November 2012. Retrieved 9 December 2013.
- ^ Tardy, M; Huhn, M; Engel, RR; Leucht, S (Aug 3, 2014). "Fluphenazine versus low-potency first-generation antipsychotic drugs for schizophrenia.". The Cochrane database of systematic reviews 8: CD009230. doi:10.1002/14651858.CD009230.pub2. PMID 25087165.
- ^ "FLUPHENAZINE HYDROCHLORIDE tablet, film coated [Sandoz Inc]". DailyMed. Sandoz Inc. October 2011. Retrieved 9 December 2013.
- ^ "Modecate Concentrate Injection 100mg/ml - Summary of Product Characteristics (SPC)". electronic Medicines Compendium. Sanofi. 11 January 2013. Retrieved 9 December 2013.
- "Fluphenazine". Davis's Drug Guide for Nurses, Eighth Edition. F.A. Davis Company, 2005. ISBN 0-8036-2455-7.
- Fluphenazine - http://www.minddisorders.com/Flu-Inv/Fluphenazine.html#b#ixzz28etEdxu8 - dose, children, effects, therapy, adults, withdrawal, drug, person
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