Zuclopenthixol Decanoate

Dosage Forms

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Injection (oily)

200 mg/ml

Uses

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Maintenance in schizophrenia and paranoid psychoses

Dose and Duration

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Schizophrenia and paranoid psychoses

Adult: by deep IM injection into upper buttock or lateral thigh, test dose 100 mg, followed at least 7 days later by 200–500 mg or more, then repeat at intervals of 1–4 weeks adjusted according to response (max 600 mg weekly).

Elderly: ¼ to ½ of usual starting dose.

In hepatic and renal impairment: ½ adult dose.

Contra-indications

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Circulatory collapse
Depressed level of consciousness
Coma
Hypersensitivity to zuclopenthixol

Side Effects

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Side effects are dose dependent and occur mostly in early phase of treatment.

Thrombocytopenia
Weight gain or loss
Anaphylactic reaction
Hyperprolactinaemia
Insomnia, somnolence
Extrapyramidal side effects, tardive dyskinesia
Neuroleptic malignant syndrome
Urinary frequency or incontinence
Injection site reactions
Gastrointestinal disturbances
Weakness, muscle pain
Visual disturbances
Vertigo

Interactions

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Amiodarone, disopyramide, parenteral erythromycin, moxifloxacin, sotalol, vandetanib (increased risk of ventricular arrhythmias)
Imipramine, amitryptyline (risk of ventricular arrhythmias; manufacturer advises avoid concomitant use)
Clozapine (avoid concomitant use; cannot be withdrawn quickly in case of neutropenia)

Patient Instructions

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Do not drive if vision is blurred or if you feel drowsy.

Pregnancy

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Do not use.

Breast-feeding

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Can be used.

⚠️ Caution

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Injection volume greater than 2 ml should be distributed between 2 injection sites.
Consider serum-level monitoring in hepatic impairment.
Avoid concomitant use of medicines which prolong QT interval.
Risk of extrapyramidal or withdrawal effects in neonate when zuclopenthixol is used in the 3ʳᵈ trimester of pregnancy. Only use if benefit to patient outweighs risk to foetus.