Fluphenazine Decanoate

Dosage Forms

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Oily Solution for Injection

25 mg/ml

Uses

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Maintenance treatment of schizophrenia and other psychoses

Dose and Duration

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Maintenance treatment of schizophrenia and other psychoses

Adult: By deep IM injection into the gluteal muscle, 12.5 mg (6.25 mg in elderly) as a single test dose. Then after 4–7 days, 12.5–100 mg is given and dose is repeated at intervals of 2–5 weeks according to response

Child: not recommended

Contraindications

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Comatose states
Severe cardiac insufficiency
Hypersensitivity to fluphenazine decanoate
Parkinsonism
Depression
Bone marrow depression
Existing blood dyscrasias
Pheochromocytoma
Marked cerebral atherosclerosis

Side Effects

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Parkinsonian symptoms: tremor, dystonia, tardive dyskinesia, akathisia
Drowsiness, lethargy
Blurred vision
Dry mouth, constipation
Urinary incontinence
Mild hypotension
Impaired judgement and mental skills
Injection site reactions

Interactions

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Amitriptyline, clomipramine (increased risk of antimuscarinic adverse effects)
Artemether+ Lumefantrine (avoid concomitant use)
Carbamazepine, ethosuximide, phenobarbital, phenytoin, valproic acid (antagonism of anticonvulsant effect)
Halothane, ketamine, nitrous oxide, thiopental (enhanced hypotensive effect)
Procainamide(increased risk of ventricular arrhythmias)
Ritonavir (plasma concentration increased by ritonavir)

Pregnancy

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Do not use in 3ʳᵈ trimester

Breast-feeding

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Can be used

⚠️ Caution

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Not recommended for use in children
Do not use in hepatic impairment due to risk of hepatotoxicity and precipitation of coma
Closely supervise patient during dose increments
Withdrawal after long-term therapy should be gradual to avoid withdrawal symptoms or relapse
Administer a test dose since side effects are prolonged
Do not use in the elderly to treat mild to moderate psychotic symptoms due to increased risk of stroke, mortality and transient ischaemic attack
Start with small doses in renal impairment