What is this medication?
Antipsychotic First Generation (Typical)
Indicated for treatment of psychotic disorders.
“Alert: Black Box Warning
Increased Mortality in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (i.e. heart failure, sudden death) or infectious (i.e. pneumonia) in nature. Fluphenazine is not approved for the treatment of patients with dementia-related psychosis.”
How does this medication work?
Fluphenazine is a piperazine phenothiazine antipsychotic which blocks postsynaptic mesolimbic dopaminergic D2 receptors in the limbic, cortical system and basal ganglia. This prevents the actions of dopamine, thereby reducing the hallucinations and delusions that are associated with schizophrenia.
How should I take this medication?
Oral: 1mg to 5mg daily.
What should I watch for while using this medication?
Before starting Fluphenazine make sure your physician is aware of any allergies or medications you currently take. Fluphenazine can alter cardiac conduction and cause life-threatening arrhythmias. Fluphenazine has anticholinergic properties which can lead constipation, xerostomia, blurred vision, urinary retention and should be used with caution in patients with decreased gastrointestinal motility, paralytic ileus, urinary retention, benign prostatic hyperplasia, xerostomia, or visual problems. Fluphenazine has been reported to cause blood dyscrasias (i.e. leukopenia, neutropenia, agranulocytosis), extrapyramidal symptoms which can include acute dystonic reactions, akathisia, and tardive dyskinesia. Patients who use Fluphenazine may be at a higher risk of falls due to orthostatic hypotension, experience hyperprolactinemia, neuroleptic malignant syndrome and ocular effects (i.e. pigmentary retinopathy, lenticular and corneal deposits).
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
The frequency of side effects is not well defined but has been reported to include the following:
Cardiac arrhythmias, edema, hypertension, hypotension, tachycardia, variable blood pressure, akathisia, bizarre dream, cerebral edema, depression, disruption of body temperature regulation, dizziness, drowsiness, dystonia, EEG pattern changes, excitement, headache, hyperreflexia, lethargy, neuroleptic malignant syndrome, Parkinsonian-like syndrome, restlessness, seizure, tardive dyskinesia, dermatitis, eczema, erythema, pruritus, seborrhea, skin photosensitivity, skin pigmentation, skin rash, urticaria, amenorrhea, change in libido, galactorrhea, gynecomastia, increased serum prolactin, menstrual disease, SIADH (syndrome of inappropriate antidiuretic hormone secretion), weight gain, aorexia, constipation, paralytic ileus, salivation, xerostomia, bladder paralysis, ejaculatory disorder, impotence, mastalgia, urinary incontinence, hematologic disturbances (i.e. agranulocytosis, eosinophilia, leukopenia, nonthrombocytopenic purpura, pancytopenia, thrombocytopenia), cholestatic jaundice, hepatotoxicity, muscle spasm (neck), systemic lupus erythematosus, tremor (fingers), blurred vision, corneal changes, glaucoma, lens disease, retinitis pigmentosa, polyuria, asthma, laryngeal edema, nasal congestion.
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