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molindone (Moban, Lindone)
Tradename: Moban.
Indications: symptomatic management of psychotic disorder
Contraindications:
1) narrow angle glaucoma
2) bone marrow depression
3) CNS depression
4) liver disease
Caution:
1) cardiovascular disease
2) seizure disorder
Dosage:
1) start 25 mg PO TID
2) adjust in 3-4 days as needed
3) start elderly on lower dose
4) max 225 mg/day
5) doses of 400 mg/day have been used
Tabs: 5, 10, 25, 50, 100 mg.
Liquid: 20 mg/mL.
Pharmacokinetics:
1) rapidly & completely absorbed from the GI tract
2) rapidly metabolized in the liver to inactive metabolites
3) < 3% excreted unchanged in the urine
Adverse effects:
1) common (> 10%)
- akathisia, extrapyramidal effects, persistent tardive dyskinesia, blurred vision, constipation, decreased sweating, dry mouth, orthostatic hypotension
2) less common (1-10%)
- depression, change in menstrual cycle, breast swelling
3) uncommon (< 1%)
- tachycardia, arrhythmias, sedation, drowsiness, restlessness, anxiety, seizures, altered temperature regulation, neuroleptic malignant syndrome, hyperpigmentation, pruritus, rash, galactorrhea, gynecomastia, weight gain, dry mouth, agranulocytosis*, leukopenia#, retinal pigmentation, photosensitivity
4) other
- low sedation, anticholinergic & orthostatic hypotensive effects
- extrapyramidal symptoms (moderate)
- tardive dyskinesia
- pseudoparkinsonism
- dystonias
- akathisia
- neuroleptic malignant syndrome (rare)
- QT prolongation
- direct myocardial suppression
* agranulocytosis is more common in women between 4th & 10th week of therapy
# leukopenia generally occurs with large doses for prolonged periods
Drug interactions:
1) see chlorpromazine
2) molindone tablets contain CaSO4 & may inhibit absorption of:
a) phenytoin
b) tetracyclines
c) quinolones
Mechanism of action:
1) intermediate potency antipsychotic agent
2) relatively selective domapine D2 receptor antagonist
3) see chlorpromazine
Interactions
drug interactions
drug adverse effects (more general classes)
Related
chlorpromazine (Thorazine, Ormazine, Propaphenin, Sonazine, Chloractil)
General
antipsychotic agent
Properties
MISC-INFO: elimination route LIVER
KIDNEY
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