trifluoperazine

Contraindicated in:

Hypersensitivity;
Cross-sensitivity with other phenothiazines may exist;
Angle-closure glaucoma;
Bone marrow depression;
Severe liver or cardiovascular disease;
Lactation: Lactation.

Use Cautiously in:

Diabetes mellitus;
Respiratory disease;
Prostatic hyperplasia;
CNS tumors;
Seizure disorder;
Intestinal obstruction;
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Pedi: Children <6 yr (safety and effectiveness not established);
Geri: Dose ↓ recommended in older adults; ↑ risk of mortality in older adults treated for dementia-related psychosis.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, tachycardia

Derm: photosensitivity, pigment changes, rash

EENT: blurred vision, dry eyes, lens opacities

Endo: amenorrhea, galactorrhea

GI: constipation, anorexia, dry mouth, hepatitis, ileus

GU: urinary retention, priapism

Hemat: AGRANULOCYTOSIS, leukopenia

Metab: hyperthermia

Neuro: extrapyramidal reactions, sedation, NEUROLEPTIC MALIGNANT SYNDROME, tardive dyskinesia

Misc: allergic reactions

Interactions ⬆ ⬇

Drug-drug:

Additive hypotension with antihypertensives, acute ingestion of alcohol, or nitrates.
Additive CNS depression with other CNS depressants, including alcohol, antihistamines, opioids, sedative/hypnotics, and general anesthetics.
Additive anticholinergic effects with other drugs having anticholinergic properties, including antihistamines, antidepressants, other phenothiazines, quinidine, and disopyramide.
Acute encephalopathy may occur with lithium.
May ↓ the effectiveness of levodopa.
↑risk of agranulocytosis with antithyroid drugs.
Lithium↓ absorption and may ↑ risk of extrapyramidal reactions.

Availability ⬆ ⬇

(Generic available)

Tablets: 1 mg; 2 mg; 5 mg; 10 mg; 20 mg

Route/Dosage ⬆ ⬇

PO (Adults ): Psychoses: 2–5 mg 1–2 times daily (up to 40 mg/day). Anxiety: 1–2 mg bid (not to exceed 6 mg/day or treatment longer than 12 wk).
PO (Children 6–12 yr): 1 mg once or twice daily (up to 15 mg/day).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Alters the effects of dopamine in the CNS.
Possesses significant anticholinergic and alpha-adrenergic blocking activity.

Therapeutic effects:

Diminished signs and symptoms of psychoses.
Reduction in anxiety.

Classifications ⬆ ⬇

Therapeutic Classification: antipsychotics (conventional)

Pharmacologic Classification: phenothiazines

Pharmacokinetics ⬆ ⬇

Absorption: Absorption from tablets is variable.

Distribution: Widely distributed, high concentrations in the CNS.

Protein Binding: ≥90%.

Metabolism/Excretion: Highly metabolized by the liver.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(antipsychotic effects)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	12–24 hr

Patient/Family Teaching ⬆ ⬇

Advise patient to take medication as directed and not to skip doses or double up on missed doses. Take missed doses as soon as remembered unless almost time for the next dose. If more than 2 doses a day are ordered, the missed dose should be taken within 1 hr of the scheduled time or omitted. Abrupt withdrawal may lead to gastritis, nausea, vomiting, dizziness, headache, tachycardia, and insomnia.
Inform patient of possibility of extrapyramidal symptoms and tardive dyskinesia. Instruct patient to report these symptoms immediately to health care provider.
May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to make position changes slowly to minimize orthostatic hypotension.
Advise patient to use sunscreen and protective clothing when exposed to the sun to prevent photosensitivity reactions. Extremes in temperature should also be avoided, because this drug impairs body temperature regulation.
Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication.
Instruct patient to use frequent mouth rinses, good oral hygiene, and sugarless gum or candy to minimize dry mouth. Consult health care professional if dry mouth continues for >2 wk.
Advise patient that increasing activity and bulk and fluids in the diet helps minimize the constipating effects of this medication.
Inform patient that this medication may turn urine pink to reddish brown.
Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
Instruct patient to notify health care professional promptly if sore throat, fever, unusual bleeding or bruising, rash, weakness, tremors, visual disturbances, dark-colored urine, or clay-colored stools occur.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy. Monitor neonates exposed to trifluoperazine during the 3rd trimester of pregnancy for extrapyramidal and/or withdrawal symptoms following delivery. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorders in these neonates.
Emphasize the importance of routine follow-up examinations to monitor response to medication and detect side effects. Periodic ocular examinations are indicated.

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇