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Fluphenazine Trade names Prolixin, Modecate AHFS /Drugs.com Monograph MedlinePlus a682172 Pregnancy category Routes of administration oral, IM , decanoate ATC code Legal status
Bioavailability 2.7% (Oral) Metabolism Hepatic (via CYP2D6 )[ 1] Elimination half-life 14.7 hours, 6-9 days (decanoate)[ 1] Excretion Urine, faeces
2-[4-[3-[2-(trifluoromethyl)-10H -phenothiazin-10-yl]propyl]piperazin-1-yl]ethanol
CAS Number PubChem CID IUPHAR/BPS DrugBank ChemSpider UNII KEGG ChEBI ChEMBL CompTox Dashboard (EPA ) ECHA InfoCard 100.000.639 Formula C 22 H 26 F 3 N 3 O S Molar mass 437.523 g/mol g·mol−1 3D model (JSmol )
FC(F)(F)c2cc1N(c3c(Sc1cc2)cccc3)CCCN4CCN(CCO)CC4
InChI=1S/C22H26F3N3OS/c23-22(24,25)17-6-7-21-19(16-17)28(18-4-1-2-5-20(18)30-21)9-3-8-26-10-12-27(13-11-26)14-15-29/h1-2,4-7,16,29H,3,8-15H2
Y Key:PLDUPXSUYLZYBN-UHFFFAOYSA-N
Y
(verify)
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
Information sources:[ 5] [ 7] [ 8]
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
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 .
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