BMA Concise Guide to Medicine & Drugs

Flupentixol

Brand names Depixol, Fluanxol

Used in the following combined preparations None

QUICK REFERENCE

Drug group Antipsychotic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Flupentixol is an antipsychotic drug that is prescribed to treat schizophrenia and similar illnesses. It is also occasionally used as an antidepressant for mild to moderate depression. The side effects from flupentixol are similar to those of phenothiazines, but flupentixol is less sedating. The drug is not suitable for any patients who suffer from mania because it may worsen the symptoms.

Flupentixol has fewer anticholinergic effects than the phenothiazines but, because it has antidopaminergic effects, it can cause side effects such as parkinsonism.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, injection.

Frequency and timing of doses 1–2 x daily no later than 4 pm (tablets); every 2–4 weeks (injection).

Adult dosage range Schizophrenia and other psychoses 6–18mg daily (tablets); from 20mg every 4 weeks to a maximum of 400mg weekly (injection). Depression 1–3mg daily (tablets).

Onset of effect 10 days (side effects may appear much sooner).

Duration of action Up to 12 hours (by mouth); 1–2 months (by depot injection).

Diet advice None.

Storage Store at room temperature out of the reach of children. Protect injections from light.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, do not take the missed dose, but take your next scheduled dose as usual.

Stopping the drug Do not stop taking the drug without consulting your doctor, who will supervise a gradual reduction in dosage. Abrupt cessation of the drug may cause withdrawal symptoms and a recurrence of the original problem.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Larger overdoses may cause severe drowsiness, seizures, low blood pressure, or shock. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

The adverse effects of flupentixol are mainly due to its anticholinergic and antidopaminergic actions and its blocking action on the transmission of signals through the heart. Weight gain, nausea, drowsiness, sexual dysfunction, breast growth, and absent periods are common; discuss with your doctor if they are severe. Blurred vision, parkinsonism, tremor, palpitations, and jaundice may also occur. If you have any of these adverse effects, you should consult your doctor; you should also stop taking the drug if you develop jaundice. If you experience dizziness, fainting, or confusion with flupentixol, you should contact your doctor immediately.

INTERACTIONS

Antiarrhythmic drugs and antibiotics (e.g. erythromycin and moxifloxacin) Taken with these drugs, flupentixol may increase the risk of arrhythmias.

Antihypertensive drugs Flupentixol may increase the effects of some antihypertensives.

Anticholinergic drugs Flupentixol may increase the effects of these drugs.

Antiparkinson drugs and anticonvulsants Flupentixol may reduce the effects of these drugs.

Sedatives Flupentixol enhances the effect of all sedative drugs.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You have heart problems.

· You have had epileptic seizures.

· You have Parkinson’s disease.

· You have glaucoma.

· You have porphyria.

· You have lactose intolerance.

· You are taking other medicines.

Pregnancy Not usually prescribed. May cause lethargy in the baby during labour. Discuss with your doctor.

Breast-feeding The drug passes into the breast milk and may affect the baby. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Reduced dose necessary. Increased risk of late-appearing movement disorders or confusion.

Driving and hazardous work Avoid such activities until you have learned how flupentixol affects you because the drug can cause drowsiness and slowed reactions.

Alcohol Avoid. Flupentixol enhances the sedative effect of alcohol.

Surgery and general anaesthetics Treatment may need to be stopped before you have any surgery. Discuss this with your doctor or dentist.

PROLONGED USE

The risk of late-appearing movement disorders increases as treatment with flupentixol continues. Blood disorders, as well as jaundice and other liver disorders, are occasionally seen.