Fluphenazine

Fluphenazine Brand Name– Prolixin | Prolixin Decanoate

What is Fluphenazine

Fluphenazine is a piperazine phenothiazine that is structurally similar to trifluoperazine, prochlorperazine, and perphenazine.

Fluphenazine is used to treat psychotic disorders and schizophrenia. A 2 mg dose of oral fluphenazine is roughly equivalent to 100 mg of chlorpromazine, the prototype antipsychotic.

Fluphenazine is most often used in patients that require depot therapy with a long-lasting injection.

Fluphenazine decanoate is a long-lasting intramuscular injection used for chronic schizophrenia or other chronic psychotic disorders. At steady-state (after 3 months on the same dose),

10 mg of fluphenazine decanoate injection given every 14 days would be equivalent to 100 mg of oral chlorpromazine given daily.

Fluphenazine enanthate, another intramuscular dosage form of fluphenazine, is rarely used clinically.

Fluphenazine was approved by the FDA in 1959.

Indications

1. agitation
2. behavioral or psychological symptoms of dementia
3. schizophrenia

For the treatment of schizophrenia

Side Effects

1. agranulocytosis
2. akathisia
3. amenorrhea
4. anaphylactoid reactions
5. angioedema
6. aplastic anemia
7. asphyxia
8. atopic dermatitis
9. blurred vision
10. breast enlargement
11. bronchospasm
12. cardiac arrest
13. cerebral edema
14. cholestasis
15. constipation
16. contact dermatitis
17. corneal opacification
18. dizziness
19. drowsiness
20. dysphagia
21. dystonic reaction
22. ejaculation dysfunction
23. eosinophilia
24. erythema
25. exfoliative dermatitis
26. fever
27. galactorrhea
28. glycosuria
29. gynecomastia
30. headache
31. hemolytic anemia
32. hepatitis
33. hyperglycemia
34. hyperhidrosis
35. hyperprolactinemia
36. hypersalivation
37. hypertension
38. hyperthermia
39. hypoglycemia
40. hyponatremia
41. hypotension
42. hypothermia
43. ileus
44. impotence (erectile dysfunction)
45. infertility
46. injection site reaction
47. jaundice
48. laryngeal edema
49. lethargy
50. leukopenia
51. libido decrease
52. lupus-like symptoms
53. mastalgia
54. menstrual irregularity
55. miosis
56. myasthenia
57. mydriasis
58. nasal congestion
59. nausea
60. neuroleptic malignant syndrome
61. neutropenia
62. orthostatic hypotension
63. pancytopenia
64. peripheral edema
65. photosensitivity
66. polydipsia
67. polyuria
68. pruritus
69. pseudoparkinsonism
70. psychosis
71. purpura
72. QT prolongation
73. retinopathy
74. seborrhea
75. seizures
76. SIADH
77. sinus tachycardia
78. skin hyperpigmentation
79. stroke
80. tardive dyskinesia
81. thrombocytopenia
82. torsade de pointes
83. urinary retention
84. urticaria
85. visual impairment
86. water intoxication
87. weight gain
88. xerostomia

Monitoring Parameters

• AIMS assessment
• CBC
• ophthalmologic exam
• serum prolactin

Contraindications

• abrupt discontinuation
• accidental exposure
• agranulocytosis
• ambient temperature increase
• angina
• anticholinergic medications
• apheresis
• AV block
• benzyl alcohol hypersensitivity
• bone marrow suppression
• bradycardia
• breast cancer
• breast-feeding
• cardiomyopathy
• celiac disease
• chemotherapy
• children
• closed-angle glaucoma
• CNS depression
• coadministration with other CNS depressants
• coma
• dehydration
• dementia
• dental work
• driving or operating machinery
• dysphagia
• encephalopathy
• ethanol ingestion
• females
• fever
• geriatric
• GI obstruction
• head trauma
• heart failure
• hematological disease
• hepatic disease
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hyperprolactinemia
• hyperthermia
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypotension
• hypothermia
• hypothyroidism
• hypovolemia
• ileus
• infants
• infection
• infertility
• intracranial mass
• intravenous administration
• jaundice
• labor
• leukopenia
• long QT syndrome
• myocardial infarction
• neonates
• neurological disease
• neutropenia
• obstetric delivery
• ocular disease
• orthostatic hypotension
• paraben hypersensitivity
• Parkinson’s disease
• phenothiazine hypersensitivity
• pheochromocytoma
• pregnancy
• pregnancy testing
• prostatic hypertrophy
• pulmonary disease
• QT prolongation
• radiographic contrast administration
• renal failure
• Reye’s syndrome
• rheumatoid arthritis
• seizure disorder
• seizures
• sesame oil hypersensitivity
• sickle cell disease
• sleep deprivation
• strenuous exercise
• stroke
• suicidal ideation
• sunlight (UV) exposure
• surgery
• systemic lupus erythematosus (SLE)
• tardive dyskinesia
• tartrazine dye hypersensitivity
• tobacco smoking
• urinary retention
• vomiting

Interactions

• Abarelix
• Acarbose
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Tramadol
• Acetohexamide
• Alfentanil
• Alfuzosin
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alosetron
• Alpha-glucosidase Inhibitors
• Alprazolam
• Amantadine
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminoglycosides
• Aminolevulinic Acid
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amobarbital
• Amoxapine
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
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• Arsenic Trioxide
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• Articaine; Epinephrine
• Asenapine
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• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir; Cobicistat
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Edrophonium
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine
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• Azithromycin
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• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
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• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
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• Carbinoxamine; Hydrocodone; Pseudoephedrine
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• Chloral Hydrate
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroquine
• Chlorothiazide
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Chlorzoxazone
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• Class IA Antiarrhythmics
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• Codeine; Promethazine
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• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmedetomidine
• Dexmethylphenidate
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diazepam
• Dicyclomine
• Diethylpropion
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Dimenhydrinate
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Disopyramide
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• Donepezil
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• Doxepin
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• Doxylamine; Pyridoxine
• Dronabinol
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• Droperidol
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• Drospirenone; Ethinyl Estradiol; Levomefolate
• Duloxetine
• Efavirenz
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• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Enalapril; Hydrochlorothiazide, HCTZ
• Encorafenib
• Entrectinib
• Ephedrine
• Epinephrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Eribulin
• Ertugliflozin
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• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
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• Estazolam
• Eszopiclone
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
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• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Ethosuximide
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• Fentanyl
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• Flucytosine
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• Fluoxetine
• Fluoxetine; Olanzapine
• Flurazepam
• Fluvoxamine
• food
• Foscarnet
• Fosinopril; Hydrochlorothiazide, HCTZ
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• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycopyrrolate
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guanidine
• Halobetasol; Tazarotene
• Halofantrine
• Halogenated Anesthetics
• Haloperidol
• Histrelin
• Homatropine; Hydrocodone
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hydroxychloroquine
• Hydroxyzine
• Hyoscyamine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Ibutilide
• Iloperidone
• Imipramine
• Incretin Mimetics
• Indacaterol; Glycopyrrolate
• Indapamide
• Inotuzumab Ozogamicin
• Insulins
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• Lithium
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