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Mellaril (Thioridazine)
Patient Information
Pronounced: MEL-ah-rill
Generic name: Thioridazine hydrochloride
Why is Mellaril prescribed?
Mellaril combats the crippling mental disorder known as schizophrenia (a
severe loss of contact with reality). Because Mellaril has been known to
cause dangerous heartbeat irregularities, it is usually prescribed only when
at least two other medications have failed.
Most important fact about Mellaril
The danger of potentially fatal cardiac irregularities increases when
Mellaril is combined with any medication that prolongs a part of the
heartbeat known as the QTc interval. Many of the drugs prescribed for
heartbeat irregularities (including Cordarone, Inderal, Quinaglute, Quinidex,
and Rythmol) prolong the QTc interval and should never be combined with
Mellaril. Other drugs to avoid when taking Mellaril include Luvox, Norvir,
Paxil, Pindolol, Prozac, Rescriptor, and Tagamet. Make sure the doctor knows
you are taking Mellaril whenever a new drug is prescribed.
How should you take Mellaril?
If you are taking Mellaril in a liquid concentrate form, you can dilute
it with a liquid such as distilled water, soft tap water, or juice just
before taking it.
Do not change from one brand of thioridazine to another without
consulting your doctor.
--If you miss a dose...
If you take 1 dose a day and remember later in the day, take the dose
immediately. If you don't remember until the next day, skip the dose and go
back to your regular schedule.
If you take more than 1 dose a day and remember the forgotten dose within
an hour or so after its scheduled time, take it immediately. If you don't
remember until later, skip the dose and go back to your regular schedule.
Never try to "catch up" by doubling a dose.
--Storage instructions...
Store at room temperature, tightly closed, in the container the
medication came in.
What side effects may occur when taking Mellaril?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Mellaril.
- Side effects of Mellaril may include: Abnormal and excessive secretion of
milk, agitation, anemia, asthma, blurred vision, body spasm, breast
development in males, changed mental state, changes in sex drive,
chewing movements, confusion (especially at night), constipation,
diarrhea, discolored eyes, drowsiness, dry mouth, excitement, eyeball
rotation, fever, fluid accumulation and swelling, headache, inability to
hold urine, inability to urinate, inhibition of ejaculation, intestinal
blockage, involuntary movements, irregular blood pressure, pulse, and
heartbeat, irregular or missed menstrual periods, jaw spasm, loss of
appetite, loss of muscle movement, mouth puckering, muscle rigidity,
nasal congestion, nausea, overactivity, painful muscle spasm, paleness,
pinpoint pupils, protruding tongue, psychotic reactions, puffing of
cheeks, rapid heartbeat, redness of the skin, restlessness, rigid and
masklike face, sensitivity to light, skin pigmentation and rash,
sluggishness, stiff, twisted neck, strange dreams, sweating, swelling in
the throat, swelling or filling of breasts, swollen glands, tremors,
vomiting, weight gain, yellowing of the skin and whites of eyes
Why should Mellaril not be prescribed?
Due to the danger of cardiac irregularities, Mellaril must never be
combined with drugs that increase its effects or prolong the part of the
heartbeat known as the QTc interval. (See "Most important fact about this
drug.") It is also important to avoid combining Mellaril with excessive
amounts of central nervous system depressants such as alcohol, barbiturates,
or narcotics. Do not take Mellaril if you have heart disease accompanied by
severe high or low blood pressure.
Special warnings about Mellaril
Mellaril may cause tardive dyskinesia--a condition marked by involuntary
muscle spasms and twitches in the face and body. This condition may be
permanent, and appears to be most common among the elderly, especially
women. Ask your doctor for information about this possible risk.
Drugs such as Mellaril are also known to cause a potentially fatal
condition known as Neuroleptic Malignant Syndrome. Symptoms of this problem
include high fever, rigid muscles, altered mental status, sweating, fast or
irregular heartbeat, and changes in blood pressure. If you develop these
symptoms, see your doctor immediately. Mellaril therapy may have to be
permanently discontinued.
In rare cases, Mellaril has been known to trigger blood disorders and
seizures. It can cause dizziness or faintness when you first stand up. High
doses can also cause vision problems, including blurring, brownish coloring
of vision, and poor night vision.
This drug may impair your ability to drive a car or operate potentially
dangerous machinery. Do not participate in any activities that require full
alertness until you are certain the drug will not interfere.
If you have ever had breast cancer, make sure your doctor is aware of it.
Mellaril may cause false positive results in tests for pregnancy.
Possible food and drug interactions when taking Mellaril
Remember that combining Mellaril with certain drugs can increase the
danger of potentially fatal heartbeat irregularities. Among the drugs to
avoid are the following:
Amiodarone (Cordarone)
Cimetidine (Tagamet)
Delavirdine (Rescriptor)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Pindolol
Propafenone (Rythmol)
Propranolol (Inderal)
Quinidine (Quinaglute, Quinidex)
Ritonavir (Norvir)
Check with your doctor before adding any new drug to your regimen.
Remember, too, that extreme drowsiness and other potentially serious effects
can result if Mellaril is combined with alcohol or other central nervous
system depressants such as narcotics, painkillers, and sleeping medications.
Special information if you are pregnant or breastfeeding
Pregnant women should use Mellaril during pregnancy only if clearly needed. If you are
pregnant or plan to become pregnant, inform your doctor immediately.
Recommended dosage for Mellaril
Your doctor will tailor your dose to your needs, using the smallest
effective amount.
ADULTS
The starting dose ranges from 50 to 100 milligrams 3 times a day. Your
doctor may gradually increase your dosage to as much as 800 milligrams a
day, taken in 2 to 4 small doses. Once your symptoms improve, your doctor
will decrease the dosage to the lowest effective amount.
CHILDREN
The usual starting dose for schizophrenic children is 0.5 milligrams per
2.2 pounds of body weight per day, divided into smaller doses. The dose may
be gradually increased to a maximum of 3 milligrams per 2.2 pounds per day.
Overdosage of Mellaril
Any medication taken in excess can have serious consequences. An overdose
of Mellaril can be fatal. If you suspect an overdose, seek medical help
immediately.
- Symptoms of Mellaril overdose may include: Agitation, blurred
vision, coma, confusion, constipation, difficulty breathing, dilated or
constricted pupils, diminished flow of urine, dry mouth, dry skin,
excessively high or low body temperature, extremely low blood pressure,
fluid in the lungs, heart abnormalities, inability to urinate,
intestinal blockage, nasal congestion, restlessness, sedation, seizures,
shock
Full Mellaril Prescribing Information
Last updated: 12/2005
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