thiothixene (Rx)

Brand and Other Names:Navane
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 1mg
  • 2mg
  • 5mg
  • 10mg

Schizophrenia

Mild-Moderate: initial: 2 mg PO q8hr; may increase to 15 mg/day

Severe: initial 5 mg PO q12hr

Maintenance: 20-30 mg/day; no more than 60 mg/day PO divided q8-12hr

Dosage Forms & Strengths

capsule

  • 1mg
  • 2mg
  • 5mg
  • 10mg

Schizophrenia

<12 years

  • Not recommended

>12 years

  • Mild-Moderate: initial: 2 mg PO q8hr; may increase to 15 mg/day
  • Severe: initial 5 mg PO q12hr
  • Maintenance: 20-30 mg/day; no more than 60 mg/day PO divided q8-12hr
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Interactions

Interaction Checker

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              Serious - Use Alternative (39)

              • abametapir

                abametapir will increase the level or effect of thiothixene by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.

              • apomorphine

                thiothixene decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • aripiprazole

                aripiprazole and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.

              • benzhydrocodone/acetaminophen

                benzhydrocodone/acetaminophen, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • bromocriptine

                thiothixene decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • cabergoline

                thiothixene decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.

              • calcium/magnesium/potassium/sodium oxybates

                thiothixene, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • carvedilol

                carvedilol, thiothixene. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).

              • clozapine

                clozapine and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.

              • degarelix

                degarelix and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.

              • dopamine

                thiothixene decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.

              • fentanyl

                fentanyl, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl intranasal

                fentanyl intranasal, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transdermal

                fentanyl transdermal, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • fentanyl transmucosal

                fentanyl transmucosal, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

              • givosiran

                givosiran will increase the level or effect of thiothixene by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.

              • hydrocodone

                hydrocodone, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • hydroxychloroquine sulfate

                hydroxychloroquine sulfate and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.

              • ivosidenib

                ivosidenib and thiothixene both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

              • levodopa

                thiothixene decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • lisuride

                thiothixene decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.

              • macimorelin

                macimorelin and thiothixene both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

              • mefloquine

                mefloquine increases toxicity of thiothixene by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

              • methyldopa

                thiothixene decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • metoclopramide intranasal

                thiothixene, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

                thiothixene increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.

              • metoprolol

                metoprolol, thiothixene. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).

              • mobocertinib

                mobocertinib and thiothixene both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

              • ondansetron

                ondansetron and thiothixene both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

              • pramipexole

                thiothixene decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.

              • propranolol

                propranolol, thiothixene. Either increases levels of the other by decreasing metabolism. Contraindicated. Not all beta blockers share this interaction (e.g., atenolol, nadolol, sotalol do not interact).

              • ropinirole

                thiothixene decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.

              • safinamide

                thiothixene decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.

              • selinexor

                selinexor, thiothixene. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • sodium oxybate

                thiothixene, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • sufentanil SL

                sufentanil SL, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • umeclidinium bromide/vilanterol inhaled

                thiothixene increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

              • vandetanib

                thiothixene, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

              • vemurafenib

                vemurafenib and thiothixene both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

              • vilanterol/fluticasone furoate inhaled

                thiothixene increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

              Monitor Closely (276)

              • abobotulinumtoxinA

                abobotulinumtoxinA increases effects of thiothixene by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • aclidinium

                aclidinium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • albuterol

                thiothixene increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • alfentanil

                alfentanil and thiothixene both increase sedation. Use Caution/Monitor.

              • almotriptan

                almotriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • alprazolam

                alprazolam and thiothixene both increase sedation. Use Caution/Monitor.

              • amifampridine

                thiothixene increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

              • amitriptyline

                thiothixene and amitriptyline both increase sedation. Use Caution/Monitor.

              • amobarbital

                amobarbital and thiothixene both increase sedation. Use Caution/Monitor.

              • amoxapine

                thiothixene and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                thiothixene and amoxapine both increase sedation. Use Caution/Monitor.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                anticholinergic/sedative combos decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • apomorphine

                thiothixene and apomorphine both increase sedation. Use Caution/Monitor.

              • arformoterol

                thiothixene increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aripiprazole

                aripiprazole and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                aripiprazole and thiothixene both increase sedation. Use Caution/Monitor.

              • armodafinil

                thiothixene increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • atracurium

                atracurium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                atracurium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • atropine

                atropine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                atropine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • atropine IV/IM

                thiothixene increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                atropine IV/IM decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                atropine IV/IM decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

              • azelastine

                azelastine and thiothixene both increase sedation. Use Caution/Monitor.

              • baclofen

                baclofen and thiothixene both increase sedation. Use Caution/Monitor.

              • bedaquiline

                thiothixene and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

              • belladonna alkaloids

                belladonna alkaloids decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                belladonna alkaloids decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • belladonna and opium

                belladonna and opium and thiothixene both increase sedation. Use Caution/Monitor.

                belladonna and opium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                belladonna and opium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • benperidol

                benperidol and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                benperidol and thiothixene both increase sedation. Use Caution/Monitor.

              • benzphetamine

                thiothixene increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • benztropine

                thiothixene increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • brexanolone

                brexanolone, thiothixene. Either increases toxicity of the other by sedation. Use Caution/Monitor.

              • brompheniramine

                brompheniramine and thiothixene both increase sedation. Use Caution/Monitor.

              • buprenorphine

                buprenorphine and thiothixene both increase sedation. Use Caution/Monitor.

              • buprenorphine buccal

                buprenorphine buccal and thiothixene both increase sedation. Use Caution/Monitor.

              • buprenorphine, long-acting injection

                thiothixene increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

              • butabarbital

                butabarbital and thiothixene both increase sedation. Use Caution/Monitor.

              • butalbital

                butalbital and thiothixene both increase sedation. Use Caution/Monitor.

              • butorphanol

                butorphanol and thiothixene both increase sedation. Use Caution/Monitor.

              • caffeine

                thiothixene increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cannabidiol

                cannabidiol, thiothixene. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.

              • carbinoxamine

                carbinoxamine and thiothixene both increase sedation. Use Caution/Monitor.

              • carisoprodol

                carisoprodol and thiothixene both increase sedation. Use Caution/Monitor.

              • cenobamate

                cenobamate, thiothixene. Either increases effects of the other by sedation. Use Caution/Monitor.

              • chloral hydrate

                chloral hydrate and thiothixene both increase sedation. Use Caution/Monitor.

              • chlordiazepoxide

                chlordiazepoxide and thiothixene both increase sedation. Use Caution/Monitor.

              • chlorpheniramine

                chlorpheniramine and thiothixene both increase sedation. Use Caution/Monitor.

              • chlorpromazine

                chlorpromazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                chlorpromazine and thiothixene both increase sedation. Use Caution/Monitor.

              • chlorzoxazone

                chlorzoxazone and thiothixene both increase sedation. Use Caution/Monitor.

              • cinnarizine

                cinnarizine and thiothixene both increase sedation. Use Caution/Monitor.

              • cisatracurium

                cisatracurium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                cisatracurium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • citalopram

                thiothixene and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

              • clemastine

                clemastine and thiothixene both increase sedation. Use Caution/Monitor.

              • clobazam

                thiothixene, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

              • clomipramine

                thiothixene and clomipramine both increase sedation. Use Caution/Monitor.

              • clonazepam

                clonazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • clonidine

                clonidine, thiothixene. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

              • clorazepate

                clorazepate and thiothixene both increase sedation. Use Caution/Monitor.

              • clozapine

                clozapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                clozapine and thiothixene both increase sedation. Use Caution/Monitor.

              • codeine

                codeine and thiothixene both increase sedation. Use Caution/Monitor.

              • crizotinib

                crizotinib and thiothixene both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

              • cyclizine

                cyclizine and thiothixene both increase sedation. Use Caution/Monitor.

                cyclizine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                cyclizine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cyclobenzaprine

                cyclobenzaprine and thiothixene both increase sedation. Use Caution/Monitor.

                cyclobenzaprine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                cyclobenzaprine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cyproheptadine

                cyproheptadine and thiothixene both increase sedation. Use Caution/Monitor.

              • dantrolene

                dantrolene and thiothixene both increase sedation. Use Caution/Monitor.

              • darifenacin

                darifenacin decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                darifenacin decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • desflurane

                desflurane and thiothixene both increase sedation. Use Caution/Monitor.

              • desipramine

                thiothixene and desipramine both increase sedation. Use Caution/Monitor.

              • deutetrabenazine

                thiothixene and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.

                thiothixene and deutetrabenazine both increase sedation. Use Caution/Monitor.

              • dexchlorpheniramine

                dexchlorpheniramine and thiothixene both increase sedation. Use Caution/Monitor.

              • dexfenfluramine

                thiothixene increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexmedetomidine

                dexmedetomidine and thiothixene both increase sedation. Use Caution/Monitor.

              • dexmethylphenidate

                thiothixene increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextroamphetamine

                thiothixene increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextromethorphan

                dextromethorphan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • dextromoramide

                dextromoramide and thiothixene both increase sedation. Use Caution/Monitor.

              • diamorphine

                diamorphine and thiothixene both increase sedation. Use Caution/Monitor.

              • diazepam

                diazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • dicyclomine

                dicyclomine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • diethylpropion

                thiothixene increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • difenoxin hcl

                difenoxin hcl and thiothixene both increase sedation. Use Caution/Monitor.

              • dihydroergotamine

                dihydroergotamine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • dimenhydrinate

                dimenhydrinate and thiothixene both increase sedation. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine and thiothixene both increase sedation. Use Caution/Monitor.

                diphenhydramine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                diphenhydramine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • diphenoxylate hcl

                diphenoxylate hcl and thiothixene both increase sedation. Use Caution/Monitor.

              • dipipanone

                dipipanone and thiothixene both increase sedation. Use Caution/Monitor.

              • dobutamine

                thiothixene increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dopamine

                thiothixene increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dopexamine

                thiothixene increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dosulepin

                thiothixene and dosulepin both increase sedation. Use Caution/Monitor.

              • doxepin

                thiothixene and doxepin both increase sedation. Use Caution/Monitor.

              • doxylamine

                doxylamine and thiothixene both increase sedation. Use Caution/Monitor.

              • droperidol

                droperidol and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                droperidol and thiothixene both increase sedation. Use Caution/Monitor.

              • eletriptan

                eletriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • ephedrine

                thiothixene increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine

                thiothixene increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine racemic

                thiothixene increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ergoloid mesylates

                ergoloid mesylates, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • ergotamine

                ergotamine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • esketamine intranasal

                esketamine intranasal, thiothixene. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

              • estazolam

                estazolam and thiothixene both increase sedation. Use Caution/Monitor.

              • ethanol

                thiothixene and ethanol both increase sedation. Use Caution/Monitor.

              • ezogabine

                ezogabine, thiothixene. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

              • fenfluramine

                thiothixene increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fentanyl

                fentanyl, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • fesoterodine

                fesoterodine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                fesoterodine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • fexinidazole

                fexinidazole will increase the level or effect of thiothixene by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • flavoxate

                flavoxate decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                flavoxate decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • flibanserin

                flibanserin, thiothixene. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • fluoxetine

                thiothixene and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

              • fluphenazine

                fluphenazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                fluphenazine and thiothixene both increase sedation. Use Caution/Monitor.

              • flurazepam

                flurazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • formoterol

                thiothixene increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • frovatriptan

                frovatriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • glycopyrrolate

                thiothixene increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • glycopyrrolate inhaled

                glycopyrrolate inhaled decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                glycopyrrolate inhaled decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • guanfacine

                guanfacine, thiothixene. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

              • haloperidol

                haloperidol and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                haloperidol and thiothixene both increase sedation. Use Caution/Monitor.

                haloperidol and thiothixene both increase QTc interval. Use Caution/Monitor.

              • henbane

                henbane decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                henbane decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • homatropine

                homatropine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                homatropine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • hydromorphone

                hydromorphone and thiothixene both increase sedation. Use Caution/Monitor.

              • hydroxyzine

                hydroxyzine and thiothixene both increase sedation. Use Caution/Monitor.

              • hyoscyamine

                hyoscyamine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • hyoscyamine spray

                thiothixene increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

              • iloperidone

                iloperidone and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                iloperidone and thiothixene both increase sedation. Use Caution/Monitor.

              • imipramine

                thiothixene and imipramine both increase sedation. Use Caution/Monitor.

              • incobotulinumtoxinA

                thiothixene increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • indacaterol, inhaled

                indacaterol, inhaled, thiothixene. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

              • ipratropium

                ipratropium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                ipratropium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • isoproterenol

                thiothixene increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketamine

                ketamine and thiothixene both increase sedation. Use Caution/Monitor.

              • ketotifen, ophthalmic

                thiothixene and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

              • lasmiditan

                lasmiditan, thiothixene. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              • lemborexant

                lemborexant, thiothixene. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

              • levalbuterol

                thiothixene increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levomilnacipran

                levomilnacipran, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • levorphanol

                levorphanol and thiothixene both increase sedation. Use Caution/Monitor.

              • linezolid

                linezolid, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • lisdexamfetamine

                thiothixene increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lithium

                lithium, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • lofepramine

                thiothixene and lofepramine both increase sedation. Use Caution/Monitor.

              • lofexidine

                thiothixene and lofexidine both increase sedation. Use Caution/Monitor.

              • loprazolam

                loprazolam and thiothixene both increase sedation. Use Caution/Monitor.

              • lorazepam

                lorazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • lorcaserin

                lorcaserin, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • lormetazepam

                lormetazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • loxapine

                loxapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                loxapine and thiothixene both increase sedation. Use Caution/Monitor.

              • loxapine inhaled

                loxapine inhaled and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                loxapine inhaled and thiothixene both increase sedation. Use Caution/Monitor.

              • lurasidone

                lurasidone, thiothixene. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

              • maprotiline

                thiothixene and maprotiline both increase sedation. Use Caution/Monitor.

              • maraviroc

                maraviroc, thiothixene. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

              • marijuana

                thiothixene and marijuana both increase sedation. Use Caution/Monitor.

              • meclizine

                meclizine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                meclizine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • melatonin

                thiothixene and melatonin both increase sedation. Use Caution/Monitor.

              • meperidine

                meperidine and thiothixene both increase sedation. Use Caution/Monitor.

                meperidine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • meprobamate

                thiothixene and meprobamate both increase sedation. Use Caution/Monitor.

              • metaproterenol

                thiothixene increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaxalone

                metaxalone and thiothixene both increase sedation. Use Caution/Monitor.

              • methadone

                methadone and thiothixene both increase sedation. Use Caution/Monitor.

                methadone, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • methamphetamine

                thiothixene increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methocarbamol

                methocarbamol and thiothixene both increase sedation. Use Caution/Monitor.

              • methscopolamine

                methscopolamine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                methscopolamine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • methylenedioxymethamphetamine

                thiothixene increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methylergonovine

                methylergonovine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • methylphenidate

                thiothixene increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.

              • metoclopramide

                thiothixene and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              • midazolam

                midazolam and thiothixene both increase sedation. Use Caution/Monitor.

              • midazolam intranasal

                midazolam intranasal, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • midodrine

                thiothixene increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • mifepristone

                mifepristone, thiothixene. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

              • milnacipran

                milnacipran, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • mirtazapine

                thiothixene and mirtazapine both increase sedation. Use Caution/Monitor.

              • modafinil

                thiothixene increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • morphine

                morphine and thiothixene both increase sedation. Use Caution/Monitor.

              • motherwort

                thiothixene and motherwort both increase sedation. Use Caution/Monitor.

              • moxonidine

                thiothixene and moxonidine both increase sedation. Use Caution/Monitor.

              • nabilone

                thiothixene and nabilone both increase sedation. Use Caution/Monitor.

              • nalbuphine

                nalbuphine and thiothixene both increase sedation. Use Caution/Monitor.

              • naratriptan

                naratriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • norepinephrine

                thiothixene increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nortriptyline

                thiothixene and nortriptyline both increase sedation. Use Caution/Monitor.

              • olanzapine

                olanzapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                olanzapine and thiothixene both increase sedation. Use Caution/Monitor.

              • oliceridine

                oliceridine, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • olodaterol inhaled

                thiothixene and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

              • onabotulinumtoxinA

                onabotulinumtoxinA decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                onabotulinumtoxinA decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • opium tincture

                opium tincture and thiothixene both increase sedation. Use Caution/Monitor.

              • orphenadrine

                orphenadrine and thiothixene both increase sedation. Use Caution/Monitor.

              • osimertinib

                osimertinib and thiothixene both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

              • oxazepam

                oxazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • oxybutynin

                oxybutynin decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • oxybutynin topical

                oxybutynin topical decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin topical decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • oxybutynin transdermal

                oxybutynin transdermal decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin transdermal decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • oxycodone

                oxycodone and thiothixene both increase sedation. Use Caution/Monitor.

              • oxymorphone

                oxymorphone and thiothixene both increase sedation. Use Caution/Monitor.

              • ozanimod

                ozanimod and thiothixene both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

              • paliperidone

                paliperidone and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                paliperidone and thiothixene both increase sedation. Use Caution/Monitor.

              • pancuronium

                pancuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                pancuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • papaveretum

                papaveretum and thiothixene both increase sedation. Use Caution/Monitor.

              • papaverine

                thiothixene and papaverine both increase sedation. Use Caution/Monitor.

              • paroxetine

                paroxetine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • pasireotide

                thiothixene and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

              • pentazocine

                pentazocine and thiothixene both increase sedation. Use Caution/Monitor.

              • pentobarbital

                pentobarbital and thiothixene both increase sedation. Use Caution/Monitor.

              • perphenazine

                perphenazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                perphenazine and thiothixene both increase sedation. Use Caution/Monitor.

              • phendimetrazine

                thiothixene increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenelzine

                phenelzine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • phenobarbital

                phenobarbital and thiothixene both increase sedation. Use Caution/Monitor.

              • phentermine

                thiothixene increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine

                thiothixene increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine PO

                thiothixene increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pholcodine

                thiothixene and pholcodine both increase sedation. Use Caution/Monitor.

              • pimozide

                pimozide and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                pimozide and thiothixene both increase sedation. Use Caution/Monitor.

              • pirbuterol

                thiothixene increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pralidoxime

                pralidoxime decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                pralidoxime decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • primidone

                primidone and thiothixene both increase sedation. Use Caution/Monitor.

              • procarbazine

                procarbazine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • prochlorperazine

                prochlorperazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                prochlorperazine and thiothixene both increase sedation. Use Caution/Monitor.

              • promethazine

                promethazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                promethazine and thiothixene both increase sedation. Use Caution/Monitor.

                promethazine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • propantheline

                propantheline decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                propantheline decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • propofol

                propofol and thiothixene both increase sedation. Use Caution/Monitor.

              • propylhexedrine

                thiothixene increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • protriptyline

                thiothixene and protriptyline both increase sedation. Use Caution/Monitor.

              • quazepam

                quazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • quetiapine

                quetiapine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                quetiapine and thiothixene both increase sedation. Use Caution/Monitor.

                quetiapine, thiothixene. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

              • quinine

                thiothixene and quinine both increase QTc interval. Use Caution/Monitor.

              • ramelteon

                thiothixene and ramelteon both increase sedation. Use Caution/Monitor.

              • rapacuronium

                rapacuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                rapacuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • remimazolam

                remimazolam, thiothixene. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

              • rilpivirine

                rilpivirine increases toxicity of thiothixene by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

              • rimabotulinumtoxinB

                thiothixene, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

              • risperidone

                risperidone and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                risperidone and thiothixene both increase sedation. Use Caution/Monitor.

              • rizatriptan

                rizatriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • rocuronium

                rocuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                rocuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rucaparib

                rucaparib will increase the level or effect of thiothixene by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

              • salmeterol

                thiothixene increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • scopolamine

                scopolamine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                scopolamine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • scullcap

                thiothixene and scullcap both increase sedation. Use Caution/Monitor.

              • secobarbital

                secobarbital and thiothixene both increase sedation. Use Caution/Monitor.

              • selegiline

                selegiline, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • selpercatinib

                selpercatinib increases toxicity of thiothixene by QTc interval. Use Caution/Monitor.

              • sevoflurane

                sevoflurane and thiothixene both increase sedation. Use Caution/Monitor.

              • shepherd's purse

                thiothixene and shepherd's purse both increase sedation. Use Caution/Monitor.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases effects of thiothixene by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases effects of thiothixene by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

              • solifenacin

                solifenacin decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                solifenacin decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • sorafenib

                sorafenib and thiothixene both increase QTc interval. Use Caution/Monitor.

              • stiripentol

                stiripentol, thiothixene. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.

                stiripentol, thiothixene. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              • sufentanil

                sufentanil and thiothixene both increase sedation. Use Caution/Monitor.

              • sumatriptan

                sumatriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • sumatriptan intranasal

                sumatriptan intranasal, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • tapentadol

                tapentadol and thiothixene both increase sedation. Use Caution/Monitor.

              • teduglutide

                teduglutide increases levels of thiothixene by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

              • temazepam

                temazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • terbutaline

                thiothixene increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • teriflunomide

                teriflunomide decreases levels of thiothixene by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

              • tetrabenazine

                thiothixene and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              • thioridazine

                thioridazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                thioridazine and thiothixene both increase sedation. Use Caution/Monitor.

              • tiotropium

                tiotropium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                tiotropium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • tolterodine

                tolterodine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                tolterodine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • topiramate

                thiothixene and topiramate both increase sedation. Modify Therapy/Monitor Closely.

              • tramadol

                tramadol and thiothixene both increase sedation. Use Caution/Monitor.

              • tranylcypromine

                tranylcypromine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • trazodone

                thiothixene and trazodone both increase sedation. Use Caution/Monitor.

              • triazolam

                triazolam and thiothixene both increase sedation. Use Caution/Monitor.

              • triclofos

                triclofos and thiothixene both increase sedation. Use Caution/Monitor.

              • trifluoperazine

                thiothixene and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                thiothixene and trifluoperazine both increase sedation. Use Caution/Monitor.

              • trihexyphenidyl

                thiothixene increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.

              • trimipramine

                thiothixene and trimipramine both increase sedation. Use Caution/Monitor.

              • triprolidine

                triprolidine and thiothixene both increase sedation. Use Caution/Monitor.

              • trospium chloride

                trospium chloride decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • vecuronium

                vecuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                vecuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • venlafaxine

                venlafaxine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • vilazodone

                vilazodone, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • voclosporin

                voclosporin, thiothixene. Either increases effects of the other by QTc interval. Use Caution/Monitor.

              • xylometazoline

                thiothixene increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • yohimbine

                thiothixene increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ziconotide

                thiothixene and ziconotide both increase sedation. Use Caution/Monitor.

              • ziprasidone

                thiothixene and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                thiothixene and ziprasidone both increase sedation. Use Caution/Monitor.

              • zolmitriptan

                zolmitriptan, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              • zotepine

                thiothixene and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

                thiothixene and zotepine both increase sedation. Use Caution/Monitor.

              Minor (9)

              • azithromycin

                azithromycin increases toxicity of thiothixene by QTc interval. Minor/Significance Unknown.

              • brimonidine

                brimonidine increases effects of thiothixene by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • chasteberry

                chasteberry decreases effects of thiothixene by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).

              • chloroquine

                chloroquine increases toxicity of thiothixene by QTc interval. Minor/Significance Unknown.

              • epinephrine

                thiothixene decreases effects of epinephrine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • epinephrine racemic

                thiothixene decreases effects of epinephrine racemic by pharmacodynamic antagonism. Minor/Significance Unknown.

              • ethanol

                ethanol, thiothixene. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

              • eucalyptus

                thiothixene and eucalyptus both increase sedation. Minor/Significance Unknown.

              • sage

                thiothixene and sage both increase sedation. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Constipation

              Decr sweating

              Drowsiness

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

              Incr appetite

              Orthostatic hypotension

              Photosensitivity

              Wt gain

              Xerostomia

              Agitation

              Allergic dermatitis

              Allergic reactions

              Anorexia

              Anticholinergic effects

              Anxiety

              Cerebral edema

              Depression

              Dizziness

              Erectile dysfunction

              Euphoria

              Headache

              Ileus

              Insomnia

              Irregular menses

              Lens opacities (prolonged use)

              Poikilothermia

              Rash

              Restlessness

              Sedation

              Tachycardia

              Weakness

              Agranulocytosis, blood dyscrasias (rare)

              Galactorrhea (rare)

              Heat stroke (rare)

              NMS (infrequent but serious)

              Obstructive hyperbilirubinemia (rare)

              Cholestatic jaundice

              Confusion

              Decr gag reflex

              Gynecomastia

              Hyperpyrexia

              Peripheral edema

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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

              Blood dyscrasias

              Coma

              Circulatory collapse

              CNS depression (including coma)

              Neuroleptic malignant syndrome (NMS)

              Poorly controlled seizure disorder

              Breastfeeding

              Cautions

              Alcohol withdrawal, cardiovascular disease, glaucoma, BPH, history of seizure disorder, Parkinsonism, urinary retention, liver disease

              Potential cross sensitivity between thioxanthenes & phenothiazine derivatives

              FDA Warning regarding off-label use for dementia in elderly

              Leukopenia/neutropenia and agranulocytosis reported; possible risk factors for leukopenia/neutropenia include pre-existing low white blood cell count (WBC) and history of drug-induced leukopenia/neutropenia

              If history of clinically significant low WBC or drug-induced leukopenia/neutropenia, monitor complete blood count (CBC) frequently during first few months of therapy; discontinue drug at first sign of a clinically significant decline <1000/mm³ in WBC in absence of other causative factors and continue monitoring WBC until recovery

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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: may be excreted in breast milk; not advised

              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

              Thioxanthene; dopamine D2 receptor antagonist; may also have anticholinergic and alpha-blocking effects

              Pharmacokinetics

              Half-life elimination: 24 hr

              Metabolism: Liver (CYP1A2)

              Protein bound: 90%

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              thiothixene oral
              -
              5 mg capsule
              thiothixene oral
              -
              2 mg capsule
              thiothixene oral
              -
              1 mg capsule
              thiothixene oral
              -
              1 mg capsule
              thiothixene oral
              -
              2 mg capsule
              thiothixene oral
              -
              5 mg capsule
              thiothixene oral
              -
              10 mg capsule
              thiothixene oral
              -
              10 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              thiothixene oral

              THIOTHIXENE - ORAL

              (thigh-oh-THICKS-een)

              COMMON BRAND NAME(S): Navane

              WARNING: There may be a slightly increased risk of serious, possibly fatal side effects (such as heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

              USES: Thiothixene is used to treat certain mental/mood disorders (such as schizophrenia). This medicine helps you to think more clearly, feel less nervous, and take part in everyday life. It can reduce aggression and the desire to hurt yourself/others. It may also help to decrease hallucinations (such as hearing/seeing things that are not there). Thiothixene is a psychiatric medication (antipsychotic-type) that works by helping to restore the balance of certain natural substances (such as dopamine) in the brain.

              HOW TO USE: Take this medication by mouth with or without food, usually 1-3 times daily or as directed by your doctor.Dosage is based on your age, medical condition, and response to treatment. To reduce your risk of side effects such as drowsiness and shaking (tremor), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's directions carefully.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.Although you may notice some medication effects soon after starting, for some conditions it may take 2 to 3 weeks before you get the full benefit of this drug.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as severe confusion and hallucinations. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.Tell your doctor if your condition does not improve or if it worsens.

              SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, lightheadedness, dry mouth, blurred vision, constipation, and trouble sleeping may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to decrease these side effects. Tell your doctor right away if you notice any of the following side effects: stiff muscles, severe muscle spasms/cramping (such as twisting neck, arching back, eyes rolling up), restlessness/constant need to move, shaking (tremor), slow/shuffling walk, drooling/trouble swallowing, mask-like expression of the face.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, confusion, depression/suicidal thoughts, difficulty urinating.This medication may cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any involuntary/repetitive muscle movements such as lip smacking/puckering, tongue thrusting, chewing, or finger/toe movements.In rare cases, thiothixene may increase your level of a certain chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.Tell your doctor right away if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (such as fever, persistent sore throat), severe stomach/abdominal pain, seizures.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: See also Warning section.Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (such as low red/white/platelet blood cell counts), a certain eye condition (glaucoma), heart problems (such as fast/irregular heartbeat, low blood pressure), liver disease, breast cancer, brain disorder/tumor/injury, drug/alcohol/substance abuse, Parkinson's disease, seizures, a certain severe reaction to other antipsychotic-type medications (neuroleptic malignant syndrome-NMS), slow movement of the gut/intestines (such as chronic constipation, intestinal blockage), difficulty urinating (such as due to prostate problems).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery or imaging procedures (such as certain X-rays, CT scans) requiring the use of contrast dye (such as metrizamide), tell your doctor or dentist that you are using this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially dizziness, lightheadedness, drowsiness, confusion, constipation, trouble urinating, extrapyramidal symptoms (EPS), and tardive dyskinesia (TD) (see Side Effects). Dizziness, lightheadedness, drowsiness, and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.Since untreated mental/mood problems (such as schizophrenia) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anticholinergic/antispasmodic drugs (such as atropine, dicyclomine, scopolamine), lithium, drugs that increase the amount of dopamine in your body (such as cabergoline, levodopa, pergolide, ropinirole), drugs that lower blood pressure (such as guanethidine, alpha blockers like prazosin).Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness, inability to wake up (coma).

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as complete blood count, eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store the American product at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom.Store the Canadian product between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom.Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              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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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.