Therapeutic Classification: antipsychotics
Pharmacologic Classification: phenothiazines
Absorption: Well absorbed after PO/IM administration. Decanoate salt in sesame oil has delayed onset and prolonged action because of delayed release from oil vehicle and subsequent delayed release from fatty tissues.
Distribution: Widely distributed. Crosses the blood-brain barrier.
Protein Binding: ≥90%.
Metabolism/Excretion: Highly metabolized by the liver; undergo enterohepatic recirculation.
Half-Life: Fluphenazine hydrochloride: 33 hr; fluphenazine decanoate: 6.8–9.6 days.
Fluphenazine Hydrochloride
Fluphenazine Decanoate
- PO (Adults ): 0.5–10 mg/day in divided doses every 6–8 hr (maximum dose = 40 mg/day).
- PO Geriatric Patients or Debilitated Patients): 1–2.5 mg/day initially; ↑ dose every 4–7 days by 1–2.5 mg/day as needed (max dose = 20 mg/day).
- IM (Adults ): 1.25–2.5 mg every 6–8 hr.
- IM (Adults ): 12.5–25 mg initially; may be repeated every 3 wk. Dose may be slowly ↑ as needed (not to exceed 100 mg/dose).
Fluphenazine hydrochloride is compatible in syringe with.
- benztropine
- diphenhydramine
- hydroxyzine
- Do not confuse fluphenazine with fluvoxamine.
- Slight yellow to amber color does not alter potency.
- To prevent contact dermatitis, avoid getting liquid preparations on hands and wash hands thoroughly if spillage occurs.
- Injectable forms must be drawn up with a dry syringe and dry 21-gauge needle to prevent clouding of the solution.
- PO: Dilute concentrate just before administration in 120–240 mL of water, milk, carbonated beverage, soup, or tomato or fruit juice. Do not mix with beverages containing caffeine (cola, coffee), tannics (tea), or pectinates (apple juice).
- SC: Fluphenazine decanoate is dissolved in sesame oil for long duration of action. It may be administered SUBQ or IM. 12.5 mg of fluphenazine decanoate given every 3 wk is approximately equivalent to 10 mg/day orally of fluphenazine hydrochloride.
- IM: IM dose of fluphenazine hydrochloride is usually 30–50% of oral dose. Because fluphenazine hydrochloride has a shorter duration of action, it is used initially to determine the patient’s response to the drug and to treat the acutely agitated patient.
- Administer deep IM, using a dry syringe and 21-gauge needle, into dorsal gluteal site. Instruct patient to remain recumbent for 30 min to prevent hypotension.
