Generic Name

Trifluoperazine

Precaution

Cardiovascular disease, epilepsy, angle-closure glaucoma, exposure to extreme temperatures, elderly, parkinson's disease, myasthenia gravis, benign prostatic hyperplasia, DM, renal amd hepatic impairment. Discontinue trifluoperazine at least 48 hr before myelography and do not resume for at least 24 hr after procedure. Do not use trifluoperazine in control of nausea and vomiting occurring either prior to myelography or postprocedure with metrizamide. Pregnancy.

Indication

Anxiety, Psychoses, Nausea and vomiting, Schizophrenia

Contra Indication

Preexisting CNS depression and coma; bone marrow depression, blood dyscrasias, liver disease, hypersensitivity to phenothiazines, prolactin dependent tumours. Pregnancy (1st trimester), lactation.

Dose

N/A

Side Effect

EPS (60%; muscle stiffness, dystonia, parkinsonism, tardive dyskinesia, akathisia), Drowsiness, dry mouth, blurred vision, dizziness, sedation, antimuscarinic affects, postural hypotension, akathisia, muscle weakness, anorexia, insomnia, rash, amenorrhoea, fatigue, increased prolactin levels. Potentially Fatal: Neuroleptic malignant syndrome, blood dyscrasias.

Pregnancy Category

Mode of Action

Trifluoperazine inhibits dopamine D2 receptors in the brain. It has weak anticholinergic and sedative effects but strong extrapyramidal and antiemetic effects. It controls severely disturbed, agitated or violent behaviour but may also be used for nonpsychotic anxiety.

Interaction

Increased CNS depression with CNS depressants such as opiates or other analgesics, barbiturates or other sedatives, general anaesthetics, or alcohol. Increased risk of side effects with drugs with antimuscarinic properties e.g. TCA, antiparkinsonian drugs. Antagonised effects of dopaminergic drugs such as levodopa. Increased risk of hypotension with antihypertensives, trazodone. Reverses antihypertensive effect of guanethidine. Increased risk of severe extrapyramidal side-effects or severe neurotoxicity with lithium. Possible decrease in absorption with antacids.

Pregnancy Category Note

Pregnancy Category: C Neonates exposed to antipsychotic drugs during the 3rd trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery These complications vary in severity; in some cases, symptoms have been self-limited, while in other cases neonates have required intensive care unit support and prolonged hospitalization Lactation: unknown

Adult Dose

Oral Psychoses, Schizophrenia Adult: Outpatient 1-2 mg PO q12hr Inpatient Initial: 2-5 mg PO q12hr Maintenance Dose: 15-20 mg/day Not to exceed 40mg/day Short-term management of anxiety Adult: 1-2 mg bid. Max: 6 mg daily. Max duration: 12 wk. Elderly: Initiate at lower dose and increase gradually.

Child Dose

Schizophrenia/Psychosis Inpatient <6 years: Safety and efficacy not established 6-12 years old: 1 mg PO qDay or q12hr; not to exceed 15 mg/day 12 years old: 2-5 mg PO q12hr

Renal Dose

N/A

Administration

Should be taken with food.