TRIFLUOPERAZINE

Phenothiazine psychotherapeutic medicine

Dosage Forms

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Tablet

5 mg

Uses

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  • Mania
  • Delirium with features of psychosis
  • Severe nausea and vomiting unresponsive to other antiemetics

Dose and Duration

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Mania and delirium with features of psychosis

Adult and child over 12 years: 5 mg twice daily, increased to 15 mg daily in 2 divided doses after 1 week, then at intervals of 3 days by 5 mg increments until satisfactory control is achieved. Then reduce dose gradually until an effective maintenance dose is achieved.

Children ˂12 years: initial oral dose should not exceed 5 mg a day in divided doses.

Severe nausea and vomiting

Adult: 2–4 mg every 12 hours (max 6 mg a day).

Child 12–18 years: 1–2 mg every 12 hours (max 6 mg a day).

Child 6–12 years: up to 2 mg every 12 hours.

Child 3–5 years: up to 0.5 mg every 12 hours.

Contra-indications

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  • Comatose states
  • CNS depression
  • Pheochromocytoma
  • Liver damage

Side Effects

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  • Drowsiness, insomnia, restlessness
  • Dry mouth, anorexia
  • Blurred vision
  • Mild postural hypotension
  • Muscular weakness, parkinsonian symptoms, dystonia, tardive dyskinesia, muscle weakness

Interactions

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  • Amiodarone (increased risk of ventricular arrhythmias)
  • Citalopram (increased risk of ventricular arrhythmias)
  • Saquinavir (increased risk of ventricular arrhythmias)

Pregnancy

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  • Do not use.

Breast-feeding

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  • Do not use.

⚠️ Caution

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  • Only use in pregnancy and lactation if it is essential.
  • Start with small doses in severe renal failure due to increased cerebral sensitivity.
  • Discontinue use at the first clinical symptom of tardive dyskinesia.
  • Reduce initial dose in elderly patients due to increased sensitivity to hypotensive and extrapyramidal effects.
  • May mask nausea and vomiting due to organic disease.
  • Restlessness due to large initial doses may resemble exacerbation of the condition being treated.
  • Clinical improvement may not be evident for several weeks after starting treatment, and there may also be delay before recurrence of symptoms after stopping treatment.
  • There is a high risk of relapse if medication is stopped after 1–2 years. Withdrawal after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse. Observe patient for up to 2 years after withdrawal.