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trifluoperazine (Rx)Brand and Other Names:Stelazine

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 1mg
  • 2mg
  • 5mg
  • 10mg
more...

Schizophrenia

Outpatient

  • 1-2 mg PO q12hr

Inpatient

  • Initial: 2-5 mg PO q12hr
  • Maintenance Dose: 15-20 mg/day
  • Not to exceed 40mg/day

Non Psychotic Anxiety

1-2 mg PO q12hr

Maximum Dose: 6 mg/day; not to exceed 12 weeks

Renal Impairment

Dose adjustment not necessary following dialysis

Dosage Forms & Strengths

tablet

  • 2mg
  • 5mg
  • 10mg
more...

Schizophrenia/Psychosis

Inpatient

  • <6 years: Safety and efficacy not established
  • 6-12 years old: 1 mg PO qDay or q12hr; not to exceed 15 mg/day
  • 12 years old: 2-5 mg PO q12hr

Initiate dosing at the low end of the range; titrate gradually

Schizophrenia

Outpatient

- 1-2 mg PO q12hr

Inpatient

- Initial: 2-5 mg PO q12hr

- Maintenance Dose:  15-20 mg/day

- Not to exceed 40mg/day

Non Psychotic Anxiety

1-2 mg PO q12hr

Maximum Dose: 6 mg/day; not to exceed 12 weeks

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Interactions

Interaction Checker

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

            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 d/o

            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, subcortical brain damage, severe cardiovascular disease, blood dyscrasias

            Lactation

            Cautions

            Avoid using in children with suspected Reye's syndrome

            Glaucoma, prostatic hypertrophy, stenosing PUD, 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

            FDA Warning regarding off-label use for dementia in elderly

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            Pregnancy & Lactation

            Pregnancy Category: C

            Neonates exposed to antipsychotic drugs during the 3rd trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery

            These complications vary in severity; in some cases, symptoms have been self-limited, while in other cases neonates have required intensive care unit support and prolonged hospitalization

            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.

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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: Liver

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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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            Select a class to view formulary status for similar drugs

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