CLOPIXOL
ZUCLOPENTHIXOL · by LUNDBECK
Composition
Inj 50 mg/100 mg: Zuclopenthixol acetate 50 mg (1 ml amp) and 100 mg (2 ml amp); oily inj, Depot Inj 200 mg: Zuclopenthixol decanoate 200 mg in 1 ml amp; oily inj. Tab 2 mg/10 mg/25 mg: Zuclo
Indications & Dosage
Schizophrenia and other psychoses: ORAL: Adult: Initially 20-30 mg daily in divided doses, increased if necessary up to 150 mg daily; usual maintenance 20-50 mg daily (max. per dose 40 mg), for debilitated patients, use elderly dose. Elderly: Initially 5-15 mg daily in divided doses, increased if necessary up to 150 mg daily; usual maintenance 20-50 mg daily (max. per dose 40 mg). BY DEEP IM INJ: Adults: Acetate form: 50-150 mg (Elderly 50-100 mg) deep IM injection into the gluteal muscle or lateral thigh, if necessary repeated after 2-3 days (1 additional dose may be needed 1-2 days after the 1st inj); Max cumulative dose 400 mg/course & max 4 inj; Max duration of treatment 2 weeks. If maintenance treatment necessary change to oral after last injection, or to a longer acting anti-psychotic depot inj given concomitantly with last inj of Zuclopenthixol acetate. Decanoate form (Depot injection): Test dose 100 mg by deep IM injection into gluteal muscle, followed after at least 7 days by 200-500 mg or more, repeated at intervals of 1-4 weeks, adjusted according to response, Max: 600 mg weekly; Elderly: Quarter to half usual starting dose.
Contraindications
Apathetic states, CNS depression, comatose states, phaeochromocytoma, withdrawn states, severe arteriosclerosis, senile confessional states, advanced renal, hepatic or cardiovascular disease, avoid in acute porphyrias
Precautions
Renal, hepatic or cardiovascular disease, ar-rhythmias, severe respiratory disease, epilepsy, Parkinsons disease, glaucoma, prostatic hypertrophy, elderly, thyroid disorders, myasthenia gravis, pheochromocytoma, risk factors for stroke, QT prolongation or venous thromboombolism. Risk of neuroleptic malignant syndrome; discontinue treatment if occurs. Risk of blood dyscrasias; monitor blood counts if signs of persistent infection. Withdraw gradually.
Interactions
Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, do-paminergics, lithium, antidiabetic agents, antihypertensives, anticonvulsants, drugs that prolong the QT interval (e.g. Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, do-paminergics, lithium, antidiabetic agents, antihypertensives, anticonvulsants, drugs that prolong the QT interval (e.g. anti-arrhythmic), metoclopramide, piperazine, general anaesthetics, neuromuscular blocking agents, anticoagulants, corticosteroids, digoxin, tricyclic antidepressants, CYP2D6 inhibitors.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated, avoid
Side Effects
Urinary frequency, urinary incontinence, weight changes, leucopenia, hyperprolactinaemia, acute dystonias and dyskinesias, akathisia, Parkinsonism, drowsiness, insomnia, agitation, tachycardia, arrhythmias, ECG changes, hypotension, anticholinergic effects (e.g. dry mouth, blurred vision), rash, photosensitivity, impaired tem-perature regulation, convulsions, male sexual dysfunction, agranulocytosis, tardive dyskinesia, jaundice, neuroleptic malignant syndrome.