CD-ROM Today 1996 January

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$Unique_ID{BRK03348} $Pretitle{} $Title{thioridazine} $Subject{Mellaril Sandoz Millazine Major Phenothiazine tranquilizer thioridazine mental illness emotional psychosis manic manic-depressive behavioral problems children depression sleep disturbances adults nerve transmission anxiety} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. thioridazine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Mellaril (Sandoz) Millazine (Major) thioridazine hydrochloride (various manufacturers) TYPE OF DRUG Phenothiazine tranquilizer INGREDIENT thioridazine DOSAGE FORMS Tablets (10 mg, 15 mg, 25 mg, 50 mg, 100 mg, 150 mg, and 200 mg) Oral concentrate (30 mg and 100 mg per ml, with 3% and 4.2% alcohol, respectively) Oral suspension (25 mg and 100 mg per 5-ml spoonful) STORAGE The tablet form of this medication should be stored at room temperature in a tightly closed, light-resistant container. The oral concentrate and oral suspension forms of this medication should be stored in the refrigerator in tightly closed, light-resistant containers. If the oral concentrate or suspension turns slightly yellowish, the medication is still effective and can be used. However, if it changes color markedly or has particles floating in it, it should not be used; rather, it should be discarded down the sink. This medication should never be frozen. USES Thioridazine 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. It may also be used for moderate to marked depression or sleep disturbances in adults. This medication is thought to relieve the symptoms of mental illness by blocking certain chemicals involved with nerve transmission in the brain. Thioridazine may also be used to treat anxiety. TREATMENT In order to avoid stomach irritation, you can take this medication with a meal or with a glass of water or milk (unless your doctor directs you to do otherwise). 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 thioridazine. The oral suspension form of this medication should be shaken well just before measuring each dose. The contents tend to settle on the bottom of the bottle, so it is necessary to shake the container to distribute the ingredients evenly and equalize the doses. Each dose should then be measured 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 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. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for your next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose (unless your doctor directs you to do so). The full effects of this medication for the control of emotional or mental symptoms may not become apparent for at least two weeks after you start to take it. SIDE EFFECTS Minor. Blurred vision, constipation, decreased sweating, diarrhea, dizziness, drowsiness, dry mouth, fatigue, jitteriness, menstrual irregularities, nasal congestion, restlessness, vomiting, and weight gain. As your body adjusts to the medication, these side effects should disappear. This medication can cause increased sensitivity to sunlight. It is, therefore, important to avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing and sunglasses, and use an effective sunscreen. Thioridazine can also cause discoloration of the urine to red, pink, or red-brown. This is a harmless effect. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, 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; drooling; fainting; fever; impotence; involuntary movements of the face, mouth, jaw, or tongue; palpitations; rash; sleep disorders; sore throat; tremors; uncoordinated movements; unusual bleeding or bruising; visual disturbances; or yellowing of the eyes or skin. INTERACTIONS Thioridazine interacts with several other medications: 1. It can cause extreme drowsiness when combined with alcohol or other central nervous system depressants (drugs that slow the activity of the brain and spinal cord), such as barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, and pain medications, or with tricyclic antidepressants. 2. Thioridazine can decrease the effectiveness of amphetamines, guanethidine, anticonvulsants, and levodopa. 3. The side effects of epinephrine, monoamine oxidase (MAO) inhibitors, metoprolol, 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. 5. False-positive pregnancy tests may occur. If you think you may be pregnant, call your doctor. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to thioridazine or any other phenothiazine tranquilizers (such as chlorpromazine, fluphenazine, mesoridazine, perphenazine, prochlorperazine, promazine, trifluoperazine, 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 in the urinary or digestive tracts, 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 enlarged prostate gland. * Tell your doctor about any recent exposure to a pesticide or an insecticide. Thioridazine may increase the side effects from the exposure. * To prevent oversedation, avoid drinking alcoholic beverages while taking this medication. * If this medication makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. 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 thioridazine. * 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, try not to become overheated (avoid exercising strenuously in hot weather, and do not take 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 suspension form of this medication on your skin or clothing; either may cause redness and irritation of the skin. * While taking this medication, do not take any over-the-counter (nonprescription) drugs for weight control or for cough, cold, allergy, asthma, or sinus problems unless you first check with your doctor. Concurrent use of any of these drugs and thioridazine may cause high blood pressure. * Your doctor may schedule regular office visits for your first few months of therapy with this medication in order to monitor your progress and possibly adjust your dosage. * Your doctor may want to schedule you for an eye examination if you take thioridazine for longer than a year. Prolonged use of this drug can cause visual disturbances. * 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. Small amounts of this medication pass into breast milk and may cause unwanted effects in nursing infants. ---------------- 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.