Therapeutic Classification: antipsychotics, mood stabilizers
Pharmacologic Classification: thienobenzodiazepines
BEERS REMS
Absorption: Well absorbed but rapidly metabolized by first-pass effect, resulting in 60% bioavailability. Conventional tablets and orally disintegrating tablets (Zydis) are bioequivalent. IM administration results in significantly higher blood levels (5 times that of oral).
Distribution: Extensively distributed.
Protein Binding: 93%.
Half-Life: 2154 hr.
(antipsychotic effects)
ROUTE | ONSET | PEAK* | DURATION |
---|---|---|---|
PO | unknown | 6 hr | unknown |
IM | rapid | 1545 min | 24 hr |
*Blood levels.
Contraindicated in:
Use Cautiously in:
CV: orthostatic hypotension, bradycardia, chest pain, syncope, tachycardia
Derm: DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), photosensitivity
EENT: amblyopia, rhinitis, ↑salivation, pharyngitis
Endo: galactorrhea, goiter, gynecomastia, hyperglycemia, hyperprolactinemia
F and E: ↑thirst
GI: ↑liver enzymes, constipation, dry mouth, weight loss, abdominal pain, dysphagia, nausea
GU: ↓fertility (females), ↓libido, amenorrhea, impotence, urinary incontinence
Hemat: AGRANULOCYTOSIS, leukopenia, neutropenia
MS: hypertonia, joint pain
Neuro: agitation, delirium, dizziness, headache, restlessness, sedation, tremor, weakness, dystonia, falls, insomnia, mood changes, NEUROLEPTIC MALIGNANT SYNDROME, personality disorder, SEIZURES, speech impairment, SUICIDAL THOUGHTS, tardive dyskinesia
Resp: aspiration, cough, dyspnea
Misc: body temperature dysregulation, fever, flu-like syndrome
Drug-drug:
Schizophrenia
Acute Manic or Mixed Episodes Associated With Bipolar I Disorder
Maintenance Treatment of Bipolar I Disorder
Acute Agitation due to Schizophrenia or Bipolar I Mania
Depressive Episodes Associated With Bipolar I Disorder
Treatment-Resistant Depression
Lab Test Considerations:
NDC Code