What is oral fluphenazine, and how does it work (mechanism of action)?
Fluphenazine is an oral antipsychotic medication
used for the management of schizophrenia. Fluphenazine is one of the older,
first-generation piperazine phenothiazine antipsychotic medications. Examples of
other phenothiazines include:
- prochlorperazine (Compazine, Compro, Procomp),
- chlorpromazine (Promapar, Thorazine),
- perphenazine, trifluoperazine (Stelazine),
and - thioridazine (Mellaril).
Although the exact mechanism of phenothiazine
antipsychotics is unknown, scientists believe that they may work by blocking the
action of dopamine in the brain. Dopamine is a neurotransmitter (chemical) that
nerves use to communicate with one another. Phenothiazine antipsychotics are
used when patients do not respond to other antipsychotics.
The FDA approved fluphenazine in September 1959.
What brand names are available for fluphenazine?
Permitil, Prolixin
Is fluphenazine available as a generic drug?
Yes
Do I need a prescription for fluphenazine?
Yes
What are the side effects of fluphenazine?
Fluphenazine causes extrapyramidal side effects such as:
- Abnormal muscle contractions
- Difficulty breathing and
swallowing - Neck spasms
Other side effects include:
Tardive dyskinesia (movement abnormalities of the face, arms, and legs)
can result from fluphenazine treatment.
Neuroleptic malignant syndrome (NMS) which includes symptoms such as fever,
muscle rigidity, altered mental status, irregular blood pressure, and irregular
heart rate and rhythm can occur. These side effects can be severe so patients
must seek medical help.
Elderly patients with
dementia-related
psychosis treated with antipsychotics are at an increased risk of death, and
fluphenazine should not be used for treating patients with dementia related
psychosis.
What is the dosage for fluphenazine?
The recommended starting dose of fluphenazine is 2.5 to 10 mg per day
orally in divided doses, every 6 to 8 hours. Doses may be increased as needed
and as tolerated to a maximum of 40 mg per day. Once symptoms are controlled,
maintenance oral doses of 1 to 5 mg per day are recommended. Dose adjustment is
based on individual response and side effects of the medication.
QUESTION
Schizophrenia is the most disabling mental illness.
See Answer
Which drugs or supplements interact with fluphenazine?
Combining fluphenazine with medications such as
procainamide (Pronestyl), sotalol (Betapace), amiodarone (Cordarone), and
dofetilide (Tikosyn) that affect heart rate and rhythm can cause abnormal heart
beats.
Antidepressants such as fluoxetine (Prozac), sertraline (Zoloft),
amitriptyline (Elavil), and nortriptyline (Pamelor) can cause an abnormal heart
rate and rhythm; ombining them with fluphenazine increases the risk of
abnormal
heart beats.
Fluphenazine should not be combined with other antipsychotics such as
aripiprazole (Abilify) and risperidone (Risperdal) because such combinations can
cause abnormal muscle contractions, difficulty breathing and swallowing, and
neck spasms. Patients should seek medical help when experiencing such effects.
Fluphenazine may increase lithium (Lithobid,
Eskolith) levels in the body. Patients may
experience increased side effects of lithium such as
increased thirst, decreased
heart rate, weakness, blurred vision, decreased concentration, and
ringing in
the ears.
Fluphenazine should be used with caution with medications that depress the
central nervous system and cause sedation or drowsiness. Examples include
alprazolam (Xanax), clonazepam (Klonopin), zolpidem (Ambien), codeine, morphine,
and alcohol. Such combinations can cause excessive sedation, drowsiness,
weakness, confusion, speech impairment, and in severe cases coma or death.
Is fluphenazine safe to take if I’m pregnant or breastfeeding?
Safe and effective use of fluphenazine is not established in
pregnant females; however, it should be avoided to prevent harm to the unborn.
Fluphenazine enters breast milk; therefore, it should be
avoided in females who are nursing.
What else should I know about fluphenazine?
What preparations of fluphenazine are available?
Oral elixir: 2.5 mg/5 ml. Oral solution: 5 mg/ml. Tablets: 1,
2.5, 5, and 10 mg.
How should I keep fluphenazine stored?
Fluphenazine tablets, oral elixir, and oral solution should be
stored between 20 C and 25 C (68 F and 77 F).