$Unique_ID{BRK03161} $Pretitle{} $Title{fluphenazine} $Subject{Permitil Schering Prolixin Princeton Phenothiazine tranquilizer fluphenazine mental illness psychosis manic manic-depressive behavioral problems chemicals nerve transmission} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. fluphenazine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Permitil (Schering) Prolixin (Princeton) TYPE OF DRUG Phenothiazine tranquilizer INGREDIENT fluphenazine DOSAGE FORMS Tablets (1 mg, 2.5 mg, 5 mg, and 10 mg) Oral concentrate (5 mg per ml, with 1% alcohol) Oral elixir (2.5 mg per 5-ml spoonful, with 14% alcohol) STORAGE The tablet form should be stored at room temperature in a tightly closed, light-resistant container. The oral concentrate and the elixir forms should be stored in the refrigerator in tightly closed, light-resistant containers. If the concentrate or elixir turns slightly yellow, the medicine is still effective and can be used. However, if it changes color markedly or has particles floating in it, it should not be used; discard it down the sink. This drug should never be frozen. USES Fluphenazine is prescribed to treat the symptoms of certain types of mental illness, such as emotional symptoms of psychosis, the manic phase of manic-depressive illness, and severe behavioral problems in children and adults. This medication is thought to relieve the symptoms of mental illness by blocking certain chemicals involved with nerve transmission in the brain. TREATMENT To avoid stomach irritation, you can take the tablet or elixir form of this medication with a meal or with a glass of water or milk (unless your doctor directs you to do otherwise). Measure the oral elixir carefully with a specially designed 5-ml measuring spoon. An ordinary kitchen teaspoon is not accurate enough. The oral concentrate form of this medication should be measured carefully with the dropper provided, then added to four ounces (1/2 cup) or more of water, milk, or a cola-free, caffeine-free carbonated beverage or to applesauce or pudding immediately prior to administration. To prevent possible loss of effectiveness, the medication should not be diluted in tea, coffee, or apple juice. Antacids and antidiarrheal medicines may decrease the absorption of this medication from the gastrointestinal tract. Therefore, at least one hour should separate doses of one of these medicines and fluphenazine. The full effects of this medication for the control of emotional or mental symptoms may not become apparent until two weeks after you start to take it. If you miss a dose of this medication, take the missed dose as soon as possible and return to your regular dosing schedule. If it is almost time for the next dose, however, skip the one you missed and return to your regular schedule. Do not double the dose (unless your doctor directs you to do so). SIDE EFFECTS Minor. Blurred vision, constipation, decreased sweating, diarrhea, dizziness, drooling, drowsiness, dry mouth, fatigue, jitteriness, menstrual irregularities, nasal congestion, restlessness, vomiting, or weight gain. As your body adjusts to the medication, these side effects should disappear. Fluphenazine can also cause discoloration of the urine to red, pink, or red-brown. This is a harmless effect. This drug can cause increased sensitivity to sunlight. Therefore, avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing, and use an effective sunscreen. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads) and drink more water (unless your doctor directs you to do otherwise). Chew sugarless gum or suck on ice chips or a piece of hard candy to reduce mouth dryness. To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about breast enlargement (in both sexes); chest pain; convulsions; darkened skin; difficulty in swallowing or breathing; fainting; fever; impotence; involuntary movements of the face, mouth, jaw, tongue, or limbs; palpitations; rash; sleep disorders; sore throat; tremors; uncoordinated movements; unusual bleeding or bruising; visual disturbances; or yellowing of the eyes or skin. Also, tell your doctor if your original symptoms worsen or change after you begin taking fluphenazine. INTERACTIONS Fluphenazine interacts with several other types of medications: 1. It can cause extreme drowsiness when combined with alcohol or other central nervous system depressants (such as barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, and pain medications) or with tricyclic antidepressants. 2. Fluphenazine can decrease the effectiveness of amphetamines, guanethidine, anticonvulsants, and levodopa. 3. The side effects of epinephrine, monoamine oxidase (MAO) inhibitors, propranolol, phenytoin, and tricyclic antidepressants may be increased by this medication. At least 14 days should separate the use of this drug and the use of an MAO inhibitor. 4. Lithium may increase the side effects and decrease the effectiveness of this medication. Before starting to take fluphenazine, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to medications, especially to fluphenazine or any other phenothiazine tranquilizers (such as chlorpromazine, mesoridazine, perphenazine, prochlorperazine, promazine, thioridazine, and triflupromazine) or to loxapine. * Tell your doctor if you have a history of alcoholism or if you now have or have ever had any blood disease, bone marrow disease, brain disease, breast cancer, blockage of the urinary or digestive tract, drug-induced depression, epilepsy, high or low blood pressure, diabetes mellitus, glaucoma, heart or circulatory disease, liver disease, lung disease, Parkinson's disease, peptic ulcers, or an enlarged prostate gland. * Tell your doctor about any recent exposure to a pesticide or an insecticide. Fluphenazine may increase the side effects from the exposure. * To prevent oversedation, avoid drinking alcoholic beverages while taking this medication. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous equipment. Be careful on stairs, and avoid getting up suddenly from a lying or sitting position. * Prior to having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Some of the side effects caused by this drug can be prevented by taking an antiparkinsonism drug. Discuss this with your doctor. * This medication can decrease sweating and heat release from the body. You should, therefore, avoid getting overheated by strenuous exercise in hot weather and should avoid hot baths, showers, and saunas. * Do not stop taking this medication suddenly. If the drug is stopped abruptly, you may experience nausea, vomiting, stomach upset, headache, increased heart rate, insomnia, tremors, or a worsening of your condition. Your doctor may want to reduce the dosage gradually. * If you are planning to have a myelogram, or any other procedure in which dye will be injected into your spinal cord, tell your doctor that you are taking this medication. * Avoid spilling the oral concentrate or elixir form of this medication on your skin or clothing; it may cause redness and irritation of the skin. * While taking this medication, do not take any over-the-counter (nonprescription) medications for weight control or for cough, cold, allergy, asthma, or sinus problems without first checking with your doctor. The combination of these medications may cause high blood pressure. * Some of these products contain the color additive FD&C Yellow No. 5 (tartrazine), which can cause allergic-type reactions (shortness of breath, rash, fainting) in certain susceptible individuals. * A potentially permanent movement disorder called tardive dyskinesia may develop with the use of this medication. It is important to discuss this with your doctor and to report any unusual or uncontrolled movements. * The elderly may be at greater risk for adverse effects when using this drug. * Be sure to tell your doctor if you are pregnant. Small amounts of this medication cross the placenta. Although there are reports of safe use of this drug during pregnancy, there are also reports of liver disease and tremors in newborn infants whose mothers received this type of medication close to term. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this medication pass into breast milk and may cause unwanted effects in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.