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
  • Anticholinergics
  • Anxiolytics; Sedatives; and Hypnotics
  • Apomorphine
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  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • 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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  • Azilsartan; Chlorthalidone
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  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
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  • Candesartan; Hydrochlorothiazide, HCTZ
  • Cannabidiol
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  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carisoprodol
  • Carteolol
  • Celecoxib
  • Cenobamate
  • Central-acting adrenergic agents
  • Ceritinib
  • Cetrorelix
  • Charcoal
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • 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
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Class IA Antiarrhythmics
  • Clemastine
  • Clindamycin; Tretinoin
  • Clobazam
  • Clofazimine
  • Clomipramine
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Crizotinib
  • Cyclobenzaprine
  • Dantrolene
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasatinib
  • Degarelix
  • Desipramine
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • 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
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Dopamine
  • Dorzolamide; Timolol
  • Doxepin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • 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
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esketamine
  • Estazolam
  • Eszopiclone
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • 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
  • Ethotoin
  • Etomidate
  • Ezogabine
  • Felbamate
  • Fenfluramine
  • Fentanyl
  • Fingolimod
  • Flavoxate
  • Flecainide
  • Flibanserin
  • Fluconazole
  • Flucytosine
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurazepam
  • Fluvoxamine
  • food
  • Foscarnet
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Fospropofol
  • Gabapentin
  • Ganirelix
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • 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
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  • 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
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  • Insulins
  • Iohexol
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  • Isoniazid, INH; Rifampin
  • Isosulfan Blue
  • Itraconazole
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  • Lapatinib
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  • Leuprolide; Norethindrone
  • Levetiracetam
  • Levodopa
  • Levofloxacin
  • Levomethadyl
  • Levorphanol
  • Linagliptin
  • Linagliptin; Metformin
  • Lithium
  • Lofexidine
  • Lomefloxacin
  • Loperamide
  • Loperamide; Simethicone
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  • Lorazepam
  • Loxapine
  • Lumateperone
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  • Phenylephrine
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  • Tranylcypromine
  • Trazodone
  • Tretinoin, ATRA
  • Triazolam
  • Triclabendazole
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimethobenzamide
  • Trimipramine
  • Triprolidine
  • Triptorelin
  • Trospium
  • Valproic Acid, Divalproex Sodium
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Verteporfin
  • Vigabatrin
  • Vitamin C
  • Voriconazole
  • Vorinostat
  • Zaleplon
  • Ziconotide
  • Ziprasidone
  • Zolpidem
  • Zonisamide
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