Fluphenazine

Fluphenazine Decanoate Injection is a long-acting parenteral antipsychotic drug intended for use in the management of patients requiring prolonged parenteral neuroleptic therapy (e.g., chronic schizophrenics). Fluphenazine Decanoate Injection has not been shown effective in the management of behavioral complications in patients with mental retardation.

• Fluphenazine Decanoate Injection may be given intramuscularly or subcutaneously
• A dry syringe and needle of at least 21 gauge should be used
• Use of a wet needle or syringe may cause the solution to become cloudy
• To begin therapy with Fluphenazine Decanoate Injection, the following regimens are suggested: For most patients , a dose of 12.5 to 25 mg (0.5 to 1 mL) may be given to initiate therapy
• The onset of action generally appears between 24 and 72 hours after injection and the effects of the drug on psychotic symptoms becomes significant within 48 to 96 hours
• Subsequent injections and the dosage interval are determined in accordance with the patient’s response
• When administered as maintenance therapy, a single injection may be effective in controlling schizophrenic symptoms up to four weeks or longer
• The response to a single dose has been found to last as long as six weeks in a few patients on maintenance therapy
• It may be advisable that patients who have no history of taking phenothiazines should be treated initially with a shorter-acting form of fluphenazine before administering the decanoate to determine the patient’s response to fluphenazine and to establish appropriate dosage
• For psychotic patients who have been stabilized on a fixed daily dosage of Fluphenazine Hydrochloride Tablets or Fluphenazine Hydrochloride Elixir conversion of therapy from these short-acting oral forms to the long-acting Fluphenazine Decanoate Injection may be indicated. …

• Phenothiazines are contraindicated in patients with suspected or established subcortical brain damage
• Phenothiazine compounds should not be used in patients receiving large doses of hypnotics
• Fluphenazine Decanoate Injection is contraindicated in comatose or severely depressed states
• The presence of blood dyscrasia or liver damage precludes the use of fluphenazine decanoate
• Fluphenazine Decanoate Injection is not intended for use in children under 12 years of age. …

Increased Mortality in Elderly Patients with Dementia-Related Psychosis Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Fluphenazine Decanoate Injection is not approved for the treatment of patients with dementia-related psychosis (see BOXED WARNING ). Tardive Dyskinesia Tardive dyskinesia, a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements, may develop in patients treated with neuroleptic (antipsychotic) drugs. …

Central Nervous System The side effects most frequently reported with phenothiazine compounds are extrapyramidal symptoms including pseudoparkinsonism, dystonia, dyskinesia, akathisia, oculogyric crises, opisthotonos, and hyperreflexia. Muscle rigidity sometimes accompanied by hyperthermia has been reported following use of fluphenazine decanoate. Most often these extrapyramidal symptoms are reversible; however, they may be persistent (see below). The frequency of such reactions is related in part to chemical structure: one can expect a higher incidence with fluphenazine decanoate than with less potent piperazine derivatives or with straight-chain phenothiazines such as chlorpromazine. …

Take it when you remember, unless it is nearly time for the next dose. Then skip the missed one. Never take two doses at once to make up for it. Check your leaflet, as some medicines are different.