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trifluoperazine (Stelazine, Suprazine)
Tradenames: Stelazine, Suprazine. (trifluoperazine hydrochloride)
Indications:
- symptomatic management of psychotic disorders
- anxiety
Contraindications:
1) narrow-angle glaucoma
2) bone marrow suppression
3) severe liver disease
Caution:
1) safety & efficacy not established in children < 6 months of age
2) severe cardiac disease
3) seizures
Dosage:
1) 1-2 mg IM every 4-6 hours.
2) 2-5 mg PO BID; max 60 mg/day
3) anxiety: 1-2 mg BID; max 6 mg/day & 12 weeks of therapy
Tabs: 1, 2, 5, 10, mg.
Liquid: 10 mg/mL.
Pharmacokinetics:
- greater psychopharmacologic potency & longer duration of action than chlorpromazine
Adverse effects:
1) common (> 10%)
- pseudoparkinsonism, akathisia, dystonia, hypotension, pigmentary retinopathy, persistent tardive dyskinesia, dizziness, constipation, decreased sweating, 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, neurolepticvmalignant syndrome, priapism, blue-gray discoloration of skin, impairment of temperature regulation, galactorrhea,leukopenia, hepatotoxicity, changes in cornea & lens
4) other
- low sedation, anticholinergic & orthostatic hypotension effects
- extrapyramidal symptoms
- tardive dyskinesia
- 10-20% of patients on long term therapy
- generally irreversible
- pseudoparkinsonism
- dystonias
- akathisia
- neuroleptic malignant syndrome (rare)
- prolongation of the QT interval
- direct myocardial depression
- lowers seizure threshold
Drug interactions:
1) other CNS depressants
2) drugs which prolong the QT interval
Laboratory:
- trifluoperazine in serum/plasma
- trifluoperazine in blood/urine
- trifluoperazine in urine
Mechanism of action:
1) high potency dopamine D2 receptor antagonist
2) see chlorpromazine
Interactions
drug interactions
drug adverse effects (more general classes)
Related
chlorpromazine (Thorazine, Ormazine, Propaphenin, Sonazine, Chloractil)
QT interval
General
antipsychotic agent
dopaminergic receptor antagonist
phenothiazine
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
- Saunders Manual of Medical Practice, Rakel (ed),
WB Saunders, Philadelphia, 1996, pg 1147
- 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