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thiothixene (Navane, Tiotixene)
Tradename: Navane. (thiothixene hydrochloride)
Indications:
- symptomatic management of psychotic disorders
Contraindications:
1) narrow-angle glaucoma
3) bone marrow suprression
4) severe liver disease
5) severe cardiac disease
Caution:
1) safety & efficacy in children < 6 months of age is not established
2) seizures
Dosage: 4 mg IM every 6-12 hours.
- start 2 mg PO TID, max 60 mg/day.
Tabs: 1, 2, 5, 10, 20 mg.
Liquid: 5 mg/5 mL.
Pharmacokinetics:
1) oral dose is well absorbed from GI tract
2) widely distributed throughout body tissues
3) metabolized by the liver
4) excreted unchanged in the feces
5) elimination 1/2life is 30 hours
6) residual drug remains in body for several weeks
Adverse effects:
1) common (> 10%)
- pseudoparkinsonism, akathisia, dystonia, hypotension, pigmentary retinopathy, persistent tardive dyskinesia, constipation, decreased sweating, dizziness, orthostatic hypotension, nasal congestion
2) 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
3) uncommon (< 1%)
- agranulocytosis, cholestatic jaundice, neuroleptic malignant syndrome, priapism, blue-gray discoloration of skin, impairment of temperature regulation, galactorrhea, leukopenia, hepatotoxicity, changes in the cornea & lens, pigmentary retinopathy
4) other
- low sedation, anticholinergic effects & orthostatic hypotension
- high incidence of extrapyramidal effects
- tardive dyskinesia
- pseudoparkinsonism
- dystonias
- akathisia
- neuroleptic malignant syndrome (rare)
- prolongation of the QT interval
- elevated serum transaminases
- lowering of seizure threshold
Drug interactions: (see chlorpromazine)
Laboratory:
1) specimen: serum
2) methods: color, fluorometry, GC-MS, HPLC
3) interferences: color & fluorometric methods lack specificity
Mechanism of action:
- high potency antipsychotic agent (see chlorpromazine)
Interactions
drug interactions
drug adverse effects (more general classes)
Related
chlorpromazine (Thorazine, Ormazine, Propaphenin, Sonazine, Chloractil)
General
antipsychotic agent
thioxanthene
Properties
MISC-INFO: elimination route LIVER
KIDNEY
1/2life 34 HOURS
therapeutic-range 10-100 NG/ML
toxic-range >100 NG/ML
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- 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
- Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed,
WB Saunders, Philadelpha 1995