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Indication & Dosage |
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| Intramuscular |
| CHRONIC PSYCHOSIS |
| Adult:
As decanoate ester: Initially, a test dose of 100 mg by deep IM into the upper outer buttock or lateral thigh to access tolerance, followed after at least 1 wk by ≥200-500 mg, repeated at 1-4 wk intervals according to response. Max dose: 600 mg wkly. Inj >2 ml to be distributed between 2 inj sites.
Elderly: Reduce dose to ¼ or ½ of usual dose. |
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| Oral |
| PSYCHOSES |
| Adult:
Initially, 20-30 mg daily in divided doses. Usual maintenance dose: 20-50 mg daily. |
| Max Dosage: 150 mg daily. |
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| Intramuscular |
| ACUTE PSYCHOSIS |
| Adult:
As acetate ester: 150 mg by deep IM into the upper outer buttock or lateral thigh, repeat if necessary after 2-3 days. Max accumulation dosage in a course: 400 mg. Max number of inj/course: 4. Max treatment duration: 2 wk.
Elderly: As acetate ester: Dose reduction may be needed. Max dose/inj: 100 mg |
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| Administration |
May be taken with or without food. |
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| Precautions |
Hepatic and renal impairment, heart disease, recent acute MI, arrhythmias, significant bradycardia (<50 beats/min), severe respiratory disease, epilepsy (and conditions at risk of epilepsy, e.g. alcohol withdrawal or brain damage), Parkinson's disease, acute angle glaucoma, prostatic hypertrophy, hypothyroidism, hyperthyroidism, myasthenia gravis, phaeochromocytoma. Patients at risk of stroke and QT interval prolongation. Avoid abrupt withdrawal. Ability to drive a car or operate machinery may be impaired. |
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Potentially Life-threatening
Adverse Drug Reactions |
Drowsiness, blurred vision, tachycardia, nausea, dizziness, headache, excitement, postural hypotension, hyperprolactinaemia, sexual dysfunction, ECG changes (prolongation of QT interval and T wave changes), hyperthermia. Extrapyramidal symptoms may occur, esp during the early phase of treatment; urinary frequency or incontinence; tardive dyskinesia. |
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| Adverse Drug Reactions |
Neuroleptic malignant syndrome, blood dyscrasias. |
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| Interactions |
Antagonise effect of apomorphine, levodopa and other dopamine agonists. Increased risk of blood dyscrasias with clozapine. Increased risk of arrhythmias with dugs that prolong QT interval e.g. class Ia and III antiarrhythmics, erythromycin or cause electrolyte disturbances e.g. thiazide diuretics. Zuclopenthixol may enhance the sedative effects of alcohol and the effects of barbiturates and other CNS depressants. Zuclopenthixol reduces the antihypertensive effect of guanethidine. Concomitant use of metoclopramide and piperazine with zuclopenthixol increases the risk of extrapyramidal symptoms. Increased risk of severe neurotoxicity with lithium and sibutramine. Increased anticholinergic side effects with drugs with anticholinergic properties. |
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