Trifluoperazine

Brand Name: Stelazine

Description

Trifluoperazine (Stelazine) is a phenothiazine used to treat nervous, mental, and emotional disorders (i.e. control anxiety or agitation in certain patients, severe nausea and vomiting, and manage certain psychotic disorders).

Indications and Usage

Anxiety, tension, agitation.

Nausea and vomiting.

The management of psychotic disorders, such as paranoid schizophrenia.

Also helps manage the manic phase of bipolar disorder.

Contraindications

Comatose or highly depressed states due to central nervous system depressants; blood dyscrasias, bone marrow depression; liver damage.

Warnings

Patients who have demonstrated a hypersensitivity reaction with a phenothiazine should not be re-exposed to any phenothiazine, including trifluoperazine, unless, in the judgement of the physician, the potential benefits of treatment outweigh the possible hazard.

If agents such as sedatives, narcotics, anesthetics, tranquilizers or alcohol are used either simultaneously or successively with trifluoperazine, the possibility of an undesirable additive depressant effect should be considered.

Precautions

Trifluoperazine should be used with caution in patients with glaucoma.

Trifluoperazine may cause an increase in mental and physical activity. In certain instances, this effect may not be desirable (i.e. angina patients have complained of increased chest pain while taking this medication.)

Rare cases of blood dyscrasias (agranulocytosis, anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia) and jaundice have been reported in patients receiving high doses of trifluoperazine.

Geriatrics and Debilitated Patients: Care should be exercised in treating elderly or debilitated patients as some appear prone to neurological adverse reactions.

Pregnancy & Nursing: Trifluoperazine should be used in women who are or might become pregnant only if the clinical condition clearly justifies potential risk to the fetus.

Data suggests that trifluoperazine is likely to be excreted in human breast milk. As a general rule, a woman taking a drug should not nurse since the possibility exists that the drug may be excreted in breast milk and be harmful to the child.

Interference with Cognitive or Motor Performance: Since trifluoperazine may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as operating an automobile or machinery, the patient should be cautioned accordingly.

Drug Interactions

Phenothiazines may diminish the effect of oral anticoagulants.

Seizures: Phenothiazines may lower the convulsive threshold; dosage adjustment of anticonvulsants may be necessary.

BEFORE USING THIS MEDICINE: INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. This includes guanethidine and medicines used to treat depression and bladder or bowel spasms. Inform your doctor of any other medical conditions including depression, seizure disorders, allergies, pregnancy, or breast-feeding.

Adverse Reactions

Phenothiazines can sometimes cause serious side effects. Tardive dyskinesia (a movement disorder) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia include fine, worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, or arms and legs. Other serious but rare side effects may also occur. These include severe muscle stiffness, fever, unusual tiredness or weakness, fast heartbeat, difficult breathing, increased sweating, loss of bladder control, and seizures (neuroleptic malignant syndrome).

Although the listing which follows includes a few adverse reactions which have not been reported with this specific drug, the pharmacological similarities among the phenothiazine drugs require that each of the reactions be considered when trifluoperazine is administered.

Side effects that may go away during treatment, include drowsiness, dizziness, nasal congestion, blurred vision, dry mouth, constipation, decreased sweating, insomnia, amenorrhea, and blurred vision. If they continue or are bothersome, check with your doctor.

Do not become overheated in hot weather, during exercise, or other activities since heat stroke may occur while you are using this medicine. This medicine may cause increased sensitivity to the sun. Avoid exposure to the sun or sunlamps until you know how you react to this medicine. Use a sunscreen or protective clothing if you must be outside for a prolonged period.

DO NOT DRINK ALCOHOL while you are taking this medicine.

BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes phenylpropanolamine.

CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience changes in vision; changes in breasts; changes in menstrual period; sore throat; inability to move eyes; muscle spasms of face, neck, or back; difficulty swallowing; mask-like face; tremors of hands; restlessness; tension in legs; shuffling walk or stiff arms or legs; puffing of cheeks; lip smacking or puckering; twitching or twisting movements; or weakness of arms or legs. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

Dependence & Withdrawl: Although phenothiazines cause neither psychic nor physical dependence, sudden discontinuance in long-term psychiatric patients may cause temporary symptoms, e.g. nausea and vomiting, dizziness, tremulousness.

Overdose

Signs and Symptoms

Symptoms of overdose may include restlessness, muscle spasms, tremors, twitching, deep sleep or loss of consciousness, and seizures.

Treatment

If you or someone you know may have used more than the recommended dose of this medicine, contact your local poison control center or emergency room immediately.

Maintain adequate airway, empty stomach contents, and treat symptomatically.

Treatment should be supportive and in response to clinical signs and symptoms. Respiration, pulse and blood pressure should be monitored and supported by general measures when necessary. Immediate gastric lavage should be performed. I.V. fluid should be administered.

Dosage

Do not exceed the recommended dosage or take this medicine for longer than prescribed.

Follow the directions for using this medicine provided by your doctor.
Store this medicine at room temperature, in a tightly-closed container, away from heat and light.
If you miss a dose of this medicine, take it as soon as possible. If you are taking 1 dose at bedtime and do not remember until the next morning, skip the missed dose and go back to your regular dosing schedule.

Additional Information: Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children.

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you are using and how long you used it.

IF YOU WILL BE USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, be sure to obtain necessary refills before your supply runs out.

For oral dosage form (suspension, solution, or tablets)- For nervous, mental, or emotional disorders:

Adults and teenagers: At first, 2 to 5 milligrams (mg) two times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 40 mg a day.

Elderly: Most geriatric patients will require 25 mg 3 times daily.

Children 6 years of age and over: 1 mg one or two times a day.

Children up to 6 years of age: Dose must be determined by your doctor.

For anxiety:

Adults and teenagers: 1 to 2 mg a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 6 mg a day, and is usually not taken for longer than twelve weeks.

Children: Dose must be determined by your doctor.

For injection dosage form-For nervous, mental, or emotional disorders:

Adults and teenagers: 1 to 2 mg, injected into a muscle every four to six hours as needed. However, the dose is usually not more than 10 mg a day.

Children 6 years of age and over: 1 mg injected into a muscle one or two times a day.

Children up to 6 years of age: Dose must be determined by your doctor.

How Supplied

Tablets:

Tablet contains: Trifluoperazine HCl available in 1 mg, 2 mg, 5 mg, 10 mg.

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The information in this monograph is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. This information is generalized and is not intended as specific medical advice. If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist, or nurse.