Flupentixol

May be taken with or without food.

Circulatory collapse, depressed level of consciousness due to any cause (e.g. alcohol intoxication, opiates, barbiturates), coma; severe depression requiring electroconvulsive therapy or hospitalisation, and states of excitement or overactivity, including mania (for 0.5 or 1 mg tab used in depression). Not recommended for use in excitable or agitated patients.

Patient with CV disease (e.g. QT prolongation), significant bradycardia, recent MI, decompensated heart failure, arrhythmias, hypovolaemia, hypokalaemia, hypomagnesaemia, severe respiratory disease, epilepsy or conditions predisposing to epilepsy (e.g. alcohol withdrawal, brain damage, head trauma), organic brain syndrome, Parkinson's disease, narrow-angle glaucoma, prostatic hypertrophy, hypothyroidism, hyperthyroidism, diabetes, myasthenia gravis, phaeochromocytoma, decreased gastrointestinal motility, paralytic ileus, urinary retention, visual problems; prolactin-dependent tumours; history of suicide-related events; risk factors for venous thromboembolism (VTE); history of or risk factors for cerebrovascular accident; at risk of aspiration pneumonia (e.g. Alzheimer's disease). Patient undergoing surgery; subjected to dehydration or strenuous exercise; exposed to extreme heat. Not approved for the treatment of elderly with dementia-related psychosis. Concomitant use with other antipsychotics. Avoid abrupt withdrawal. Debilitated patients. Elderly. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, drowsiness, or blurred vision; if affected, do not drive or operate machinery. Monitoring Parameters Correct electrolyte abnormalities prior to initiation of treatment. Monitor ECG, blood pressure, body weight; CBC, electrolytes, LFTs, fasting plasma glucose level/HbA_1c and lipid panel as clinically indicated. Check for clinical worsening, suicidal thoughts, or unusual changes in behaviour; involuntary movements or parkinsonian signs, tardive dyskinesia; signs and symptoms of neuroleptic malignant syndrome (e.g. mental status changes, fever, muscle rigidity). Perform ocular examination yearly in patients >40 years.

Significant: Extrapyramidal symptoms (e.g. akathisia, dystonia, tardive dyskinesia), QT prolongation, VTE, cerebrovascular events, anticholinergic effects (e.g. xerostomia, blurred vision, constipation, urinary retention), blood dyscrasias (e.g. agranulocytosis, neutropenia, leucopenia, thrombocytopenia), diabetic ketoacidosis, oesophageal dysmotility and aspiration, falls, orthostatic hypotension, impaired core body temperature regulation, increased prolactin levels; withdrawal symptoms. Rarely, lens opacity. Cardiac disorders: Palpitation, tachycardia. Eye disorders: Abnormal vision, accommodation disorder. Gastrointestinal disorders: Nausea, vomiting, dyspepsia, diarrhoea, sialorrhoea. General disorders and administration site conditions: Fatigue, asthenia. Investigations: Increased weight. Metabolism and nutrition disorders: Increased appetite. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Dizziness, drowsiness, headache, hyper- or hypokinesia, tremor. Psychiatric disorders: Depression, insomnia, nervousness, agitation, disturbance in attention. Renal and urinary disorders: Micturition disorder. Reproductive system and breast disorders: Decreased libido. Respiratory, thoracic and mediastinal disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Hyperhidrosis, pruritus.
Potentially Fatal: Suicidal thoughts or attempts, arrhythmias, neuroleptic malignant syndrome.

May potentiate the effects of other CNS depressants, barbiturates, general anaesthetics, and anticoagulants. May increase risk of QT interval prolongation with class Ia and III antiarrhythmics (e.g. quinidine, sotalol), erythromycin, moxifloxacin, cisapride, thioridazine, and thiazide diuretics. May prolong the action of neuromuscular blocking agents. May potentiate the anticholinergic effects of atropine. May increase risk of extrapyramidal effects with metoclopramide and piperazine. May enhance the hypotensive effects of hydralazine, doxazosin, and methyldopa. May reverse the antihypertensive effects of guanethidine. Increased risk of neurotoxicity with lithium and sibutramine. Efficacy of adrenergic agents, levodopa and anticonvulsants may be impaired. May inhibit the metabolism of TCAs; antagonise the effects of epinephrine and sympathomimetics. Insulin and glucose responses may be modified by flupentixol.

Antidepressants / Antipsychotics

N05AF01 - flupentixol ; Belongs to the class of thioxanthene derivatives antipsychotics.