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Fluphenazine (Prolixin®, Permitil®)

By: Dr. Nicholas Dodman

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Overview

  • Fluphenazine hydrochloride is a neuroleptic. It works by depressing the central nervous system.
  • In humans, fluphenazine is used to manage schizophrenia and emotional disorders. It is used occasionally as a sedative in domestic animals.
  • Fluphenazine is classified chemically as a trifluoro-methyl phenothiazine derivative. Related drugs include acepromazine and chlorpromazine. Phenothiazines act on the reticular activating system
  • The exact mechanism of action of phenothiazine derivatives is not completely understood but they are thought to block dopamine receptors in the brain.
  • Fluphenazine is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian. This drug is not approved for use in animals by the Food and Drug Administration (FDA) but it is prescribed legally as an extra-label drug.

    Brand Names and Other Names

  • Fluphenazine is registered for use in humans only.
  • Human formulations: Prolixin® (Princeton), Permitil® (Schering) and various generic preparations
  • Veterinary formulations: None

    Uses of Fluphenazine

  • Fluphenazine can be used as a mild sedative, though it is more likely than other phenothiazines to induce movement disorders.
  • It has been suggested that dopamine-blocking agents, like fluphenazine, may be useful in the treatment of obsessive-compulsive disorder in animals.

    Precautions and Side Effects

  • Information on the use of fluphenazine in dogs and cats is scarce and clinical information about its use in these species is non-existent.
  • Because of fluphenazine's shortcomings, and the absence of valid clinical dose data, it is unwise to employ this drug anything less than tentatively, at the lowest possible doses, and with only the strictest monitoring.
  • Fluphenazine should also be avoided in animals with glaucoma, pyloric stenosis, prostatic hypertrophy, hypotension, or shock.
  • Constipation, sedation, and hypotension may occur following its administration.
  • Fluphenazine should be used with caution in animals with liver disease, heart disease, and in elderly patients.
  • The drug should also be used with caution in patients with a known history of seizures because it lowers the seizure threshold.
  • Severe adverse reactions may sometimes occur and are difficult to predict. Therefore, the evaluation of tolerance and response to fluphenazine require close medical observation and supervision.
  • In cases of overdose, fluphenazine may cause tremors, drooling, seizures, and/or Parkinson's-like effects.
  • Fluphenazine may interact with other medications. Consult your veterinarian to determine if other drugs your pet is receiving could interact with fluphenazine. Such drugs include barbiturates, narcotics, anesthetics, antidiarrheals, antacids, propranolol and epinephrine.

    How Fluphenazine is Supplied

  • Fluphenazine is available as 1 mg, 2.5 mg, 5 mg and 10 mg tablets.
  • Fluphenazine is also available in injectable form at a concentration of 100 mg per ml.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian. Initial administration will likely take place in a veterinary setting. The pet should be watched carefully afterwards for signs of side effects or drug interactions.
  • The dose of oral preparations (tablets) is unknown in dogs and cats but is probably in the range of 0.06 mg per kg (2.2 pounds).
  • The dosing frequency during long-term use should probably be twice daily.
  • The dose of the long-acting injection is somewhere between 2.1 mg per kg and 6.3 mg per kg given every 2 to 4 weeks.
  • Onset of action takes 24 to 72 hours. It is advisable to give a small test dose of the preparation before giving the full dose.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription as specifically directed by your veterinarian.




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