trifluoperazine (Stelazine, Suprazine)
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Introduction
Tradenames: Stelazine, Suprazine. (trifluoperazine hydrochloride)
Indications
- symptomatic management of psychotic disorders
- anxiety
Contraindications
Caution:
- safety & efficacy not established in children < 6 months of age
- severe cardiac disease
- seizures
Dosage
- 1-2 mg IM every 4-6 hours.
- 2-5 mg PO BID; max 60 mg/day
- anxiety: 1-2 mg BID; max 6 mg/day & 12 weeks of therapy
Tabs: 1, 2, 5, 10, mg.
Liquid: 10 mg/mL.
Pharmacokinetics
- greater psychopharmacologic potency & longer duration of action than chlorpromazine
elimination via liver
elimination via kidney
Adverse effects
- common (> 10%)
- less common (1-10%)
- difficulty urinating, photosensitivity, rash, changes in menstrual cycle, sexual dysfunction, breast pain, weight gain, nausea/vomiting, epigastric pain, trembling of fingers
- uncommon (< 1%)
- agranulocytosis, cholestatic jaundice, neurolepticvmalignant syndrome, priapism, blue-gray discoloration of skin, impairment of temperature regulation, galactorrhea,leukopenia, hepatotoxicity, changes in cornea & lens
- other
- low sedation, anticholinergic & orthostatic hypotension effects
- extrapyramidal symptoms
- tardive dyskinesia
- 10-20% of patients on long term therapy
- generally irreversible
- pseudoparkinsonism
- dystonias
- akathisia
- tardive dyskinesia
- neuroleptic malignant syndrome (rare)
- prolongation of the QT interval
- direct myocardial depression
- lowers seizure threshold
- drug adverse effects of antipsychotic agents
- drug adverse effects of psychotropic agents
- drug adverse effects of dopaminergic receptor antagonists
- drug adverse effects of antihypertensive agents
Drug interactions
- other CNS depressants
- drugs which prolong the QT interval
- drug interaction(s) of lithium carbonate with phenothiazine
- drug interaction(s) of antipsychotics & dopamine receptor agonists
- drug interaction(s) of antipsycotics with benzodiazepines
- drug interaction(s) of beta-adrenergic receptor antagonists with phenothiazines
- drug interaction(s) of NSAIDs & antihypertensives
Laboratory
Mechanism of action
- high potency dopamine D2 receptor antagonist
- see chlorpromazine
More general terms
Additional terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1147
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998