Fluphenazine: Difference between revisions
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'''Fluphenazine''' (sold under the brand names Prolixin, Modecate) is a [[typical antipsychotic]] [[medication|drug]] used for the treatment of chronic [[psychosis|psychoses]] such as [[schizophrenia]].<ref name="BNF">{{cite book | isbn = 978-0-85711-084-8 | title = British National Formulary (BNF) | last1 = Joint Formulary Committee | year = 2013 | publisher = Pharmaceutical Press | location = London, UK | edition = 65 | pages = 237, 238 }}</ref><ref name="AMH">{{cite book | editor = Rossi, S | isbn = 978-0-9805790-9-3 | title = Australian Medicines Handbook | place = Adelaide | publisher = The Australian Medicines Handbook Unit Trust | year = 2013 | edition = 2013 }}</ref> It is a [[phenothiazine]] with a [[piperazine]] side-chain. It works by antagonising (blocking) the [[dopamine D2 receptor]]s in the brain. This also leads to some of its side effects like movement disorders (like [[parkinsonism]] and [[akathisia]]) and [[prolactin]] elevation. It is given via an [[intramuscular]] or [[Subcutaneous injection|subcutaneous]] [[depot]] injection (as its [[decanoate]] |
'''Fluphenazine''' (sold under the brand names Prolixin, Modecate) is a [[typical antipsychotic]] [[medication|drug]] used for the treatment of chronic [[psychosis|psychoses]] such as [[schizophrenia]].<ref name="BNF">{{cite book | isbn = 978-0-85711-084-8 | title = British National Formulary (BNF) | last1 = Joint Formulary Committee | year = 2013 | publisher = Pharmaceutical Press | location = London, UK | edition = 65 | pages = 237, 238 }}</ref><ref name="AMH">{{cite book | editor = Rossi, S | isbn = 978-0-9805790-9-3 | title = Australian Medicines Handbook | place = Adelaide | publisher = The Australian Medicines Handbook Unit Trust | year = 2013 | edition = 2013 }}</ref> It is a [[phenothiazine]] with a [[piperazine]] side-chain. It works by antagonising (blocking) the [[dopamine D2 receptor]]s in the brain. This also leads to some of its side effects like movement disorders (like [[parkinsonism]] and [[akathisia]]) and [[prolactin]] elevation. It is given via an [[intramuscular]] or [[Subcutaneous injection|subcutaneous]] [[depot]] injection (as its [[decanoate]] ester) or by mouth in the form of tablets.<ref name = MD>{{cite web|title=Fluphenazine|work=Martindale: The Complete Drug Reference|publisher=Pharmaceutical Press|date=13 December 2013|accessdate=14 July 2014|url=https://www.medicinescomplete.com/mc/martindale/current/ms-17391-h.htm|location=London, UK|editor=Brayfield, A}}</ref> In some countries only the depot formulations are currently available.<ref name = BNF/><ref name = AMH/> Compared to other antipsychotics it is less prone to causing [[sedation]], [[hypotension|low blood pressure]] or [[anticholinergic]] effects but is associated with a higher frequency of movement disorders.<ref name = MD/> |
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It is on the [[World Health Organization's List of Essential Medicines]], a list of the most important medication needed in a basic [[health system]].<ref>{{cite web|title=WHO Model List of Essential Medicines|url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1|work=World Health Organization|accessdate=22 April 2014|date=October 2013}}</ref> |
It is on the [[World Health Organization's List of Essential Medicines]], a list of the most important medication needed in a basic [[health system]].<ref>{{cite web|title=WHO Model List of Essential Medicines|url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1|work=World Health Organization|accessdate=22 April 2014|date=October 2013}}</ref> |
Revision as of 15:13, 25 May 2015
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Clinical data | |
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Trade names | Prolixin, Modecate |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682172 |
Pregnancy category |
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Routes of administration | oral, IM, decanoate |
ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | 2.7% (Oral) |
Metabolism | Hepatic (via CYP2D6)[1] |
Elimination half-life | 14.7 hours, 6-9 days (decanoate)[1] |
Excretion | Urine, faeces |
Identifiers | |
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CAS Number | |
PubChem CID | |
IUPHAR/BPS | |
DrugBank | |
ChemSpider | |
UNII | |
KEGG | |
ChEBI | |
ChEMBL | |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.000.639 |
Chemical and physical data | |
Formula | C22H26F3N3OS |
Molar mass | 437.523 g/mol g·mol−1 |
3D model (JSmol) | |
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Fluphenazine (sold under the brand names Prolixin, Modecate) is a typical antipsychotic drug used for the treatment of chronic psychoses such as schizophrenia.[2][3] It is a phenothiazine with a piperazine side-chain. It works by antagonising (blocking) the dopamine D2 receptors in the brain. This also leads to some of its side effects like movement disorders (like parkinsonism and akathisia) and prolactin elevation. It is given via an intramuscular or subcutaneous depot injection (as its decanoate ester) or by mouth in the form of tablets.[1] In some countries only the depot formulations are currently available.[2][3] Compared to other antipsychotics it is less prone to causing sedation, low blood pressure or anticholinergic effects but is associated with a higher frequency of movement disorders.[1]
It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[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]
Adverse 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 Brayfield, A, ed. (13 December 2013). "Fluphenazine". Martindale: The Complete Drug Reference. London, UK: Pharmaceutical Press. Retrieved 14 July 2014.
- ^ a b Joint Formulary Committee (2013). British National Formulary (BNF) (65 ed.). London, UK: Pharmaceutical Press. pp. 237, 238. ISBN 978-0-85711-084-8.
- ^ a b Rossi, S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.
- ^ "WHO Model List of Essential Medicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
- ^ 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