thioridazine (Rx)Brand and Other Names:Mellaril

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 10mg
  • 25mg
  • 50mg
  • 100mg
more...

Schizophrenia

Initial 50-100 mg PO q8hr, THEN

200-800 mg/day PO divided q6-12hr

Depressive Disorders

25 mg PO q8hr; may titrate to effect (20-200 mg/day)

Renal Impairment

Dose adjustment not necessary in dialysis

Hepatic Disease

Initiate treatment at lower dose and titrate to effect (monitor)

Other Indications & Uses

Psychotic disorders, geriatric psychoneurotic manifestations, pediatric behavioral disorders

Dosage Forms & Strengths

tablet

  • 10mg
  • 25mg
  • 50mg
  • 100mg
more...

Schizophrenia

<2 years: Safety and efficacy not established

2-12 years: 0.5-3 mg/kg/day divided q8hr PO, no more than 3 mg/kg/day 

>12 years: Initial 50-100 mg PO q8hr; titrate to 200-800 mg/day PO divided q6-12hr

Potential toxic dose <6 years old: 3 mg/kg

Initiate treatment at lower dose and titrate to effect (monitor)

Schizophrenia

Initial 50-100 mg PO q8hr, THEN

200-800 mg/day PO divided q6-12hr

Debilitated patients: Initiate treatment at lower dose

Depressive disorders

25 mg PO q8hr; may titrate to effect (20-200 mg/day)

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Interactions

Interaction Checker

thioridazine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            EPS (muscle stiffness, dystonia, parkinsonism, tardive dyskinesia, akathisia) (60%)

            NMS (infrequent but serious)

            Sedation

            Anticholinergic effects

            Weight gain

            Oligomenorrhea/amenorrhea

            Erectile dysfunction

            Insomnia

            Restlessness

            Anxiety

            Euphoria

            Agitation

            Depression

            Weakness

            Headache

            Cerebral edema

            Poikilothermia

            Orthostatic hypotension

            Tachycardia

            Dizziness

            Lens opacities (prolonged use)

            Anorexia

            Dyspepsia

            Constipation

            Ileus

            Blood dyscrasia

            ECG changes

            Photosensitivity

            Pruritis

            Diarrhea

            Galactorrhea

            Ejaculatory disorder

            Seizure (rare)

            Priapism (rare)

            Cholestatic jaundice (rare)

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            Warnings

            Black Box Warnings

            Patients with dementia-related psychosis who are treated with antipsychotic drugs are at an increased risk of death as shown in short-term controlled trials. The deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature

            This drug is not approved for the treatment of patients with dementia-related psychosis

            Contraindications

            Documented hypersensitivity to phenothiazines

            Coma, severe hypotension, severe CNS depression, concurrency with large amounts of CNS depressants, poorly controlled seizure disorder, myelosuppression, subcortical brain damage

            Any drugs or conditions that prolong QTc interval

            Lactation

            Cautions

            Avoid using in children with suspected Reye's syndrome

            Glaucoma, prostatic hypertrophy, stenosing PUD, tardive dyskinesia, history of NMS, Parkinson's disease, hypocalcemia, renal/hepatic impairment, patients who have exhibited a severe reaction to insulin or ECT, history of seizures, asthma, respiratory tract infections, cardiovascular disease

            Risk of EPS, NMS, hypotension

            Hypotension may be particularly severe in patients with pheochromocytoma or mitral insufficiency

            Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia

            In case of severe hypotension, use norepinephrine or phenylepinephrine, do NOT use epinephrine or dopamine

            May need anticholinergic antiparkinsonian agent to counter EPS

            Sales being discontinued in Canada

            FDA Warning regarding off-label use for dementia in elderly

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Piperazine phenothiazine agent; antagonist for the postsynaptic mesolimbic dopaminergic D2 receptors in the brain; decreases the release of hypothalamic and hypophyseal hormones

            Pharmacokinetics

            Half-Life elimination: 24 hr

            Metabolism: Hepatic P450 enzyme CYP2D6

            Enzymes inhibited: CYP2D6

            Protein bound: 95%

            Duration: 4-5 days

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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