thiothixene

Contraindicated in:

Hypersensitivity to thiothixene or other phenothiazines (cross-sensitivity may occur);
Circulatory collapse;
Blood dyscrasias;
CNS depression;
Lactation: Lactation.

Use Cautiously in:

Diabetes mellitus;
Respiratory disease;
Prostatic hypertrophy;
CNS tumors;
Epilepsy;
Intestinal obstruction;
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Pedi: Safety and effectiveness not established in children;
Geri: Appears on Beers list. ↑ risk of stroke, cognitive decline, and mortality in older adults with dementia. Avoid use in older adults, except for schizophrenia.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, nonspecific ECG changes, tachycardia

Derm: photosensitivity, pigment changes, rash

EENT: blurred vision, dry eyes, lens opacities

Endo: amenorrhea, breast enlargement, galactorrhea

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

GU: urinary retention

Hemat: AGRANULOCYTOSIS, leukocytosis, leukopenia, neutropenia

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

Misc: allergic reactions, hyperpyrexia

Interactions ⬆ ⬇

Drug-drug:

Additive hypotension with antihypertensives, acute ingestion of alcohol, and nitrates.
Additive hypotension may occur if epinephrine is given to treat hypotension.
Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, and sedative/hypnotics.
Additive anticholinergic effects with other drugs having anticholinergic properties, including antihistamines, antidepressants, quinidine, or disopyramide.
May ↓ the effectiveness of levodopa.
↑risk of cardiac effects with quinidine.

Drug-Natural Products:

Concomitant use of kava-kava, valerian, skullcap, chamomile, or hops can ↑ CNS depression.

Availability ⬆ ⬇

(Generic available)

Capsules: 1 mg; 2 mg; 5 mg; 10 mg

Route/Dosage ⬆ ⬇

PO (Adults ): Mild conditions: 2 mg 3 times daily (up to 15 mg/day if necessary; Severe conditions: 5 mg twice daily (up to 20–30 mg/day; not to exceed 60 mg/day).

Action ⬆ ⬇

Alters the effect of dopamine in the CNS.

Therapeutic effects:

Diminished signs and symptoms of psychoses.

Classifications ⬆ ⬇

Therapeutic Classification: antipsychotics (conventional)

Pharmacologic Classification: thioxanthenes

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Mainly metabolized by the liver.

Half-Life: 30 hr.

Time/Action Profile ⬆ ⬇

(antipsychotic effects)

ROUTE	ONSET	PEAK	DURATION
PO	days–wks	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient on need to take medication as directed. Take missed doses as soon as remembered unless 2 hr before next dose. Do not double doses. Patients on long-term high-dose therapy may need dose tapered to avoid withdrawal symptoms (dyskinesia, tremors, dizziness, nausea, and vomiting).
Drowsiness may occur. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Inform patient of possibility of extrapyramidal symptoms and tardive dyskinesia. Caution patient to report these symptoms immediately to health care professional.
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 bulk and fluids in the diet and exercising may help minimize the constipating effects of this medication.
Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Caution patient to avoid concurrent use of alcohol and other CNS depressants during therapy.
Caution patient to avoid exercising in hot weather and taking very hot baths, because this drug impairs temperature regulation.
Instruct patient to notify health care professional promptly if sore throat, fever, skin rashes or discoloration, weakness, tremors, visual disturbances, menstrual abnormalities, galactorrhea or sexual dysfunction are noted.
Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
Rep: Advise patient to use effective contraception during therapy and to notify health care professional immediately if pregnancy is suspected and to avoid breastfeeding during therapy. May cause neonatal extrapyramidal and/or withdrawal symptoms (agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, feeding disorder) following delivery if taken during third trimester.
Emphasize the importance of continued medical follow-up for psychotherapy, eye exams, and laboratory tests, and to monitor response to medication and detect side effects.

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Indications ⬇

Contraind./Precautions ⬆ ⬇