Fluanxol: instructions for use, doctors' reviews and price

Compound

flupenthixol as an active ingredient .
Auxiliary ingredients: lactose monohydrate, potato starch, gelatin, magnesium stearate, talc.

Shell: sucrose, gelatin, E172.

One milliliter of injection solution contains 20 mg or 100 mg of cis(Z)-flupenthixol decanoate , the active substance.

Additional components: medium chain triglycerides.

Pharmacodynamics and pharmacokinetics

A thioxanthene derivative , flupenthixol is an antipsychotic (psychotropic drug) with a pronounced activating, anxiolytic and antipsychotic effect.

The antipsychotic effects of the drug are associated with blocking dopamine receptors of 5-HT serotonin receptors is also suggested . Fluanxol has been proven to reduce the main symptoms of psychosis , including thinking disorders , paranoid delusions , and hallucinations .

The antipsychotic effectiveness of Fluanxol is observed when taking tablets orally at a daily dose of 3 mg. An increase in effect is observed with increasing both oral and intramuscular dosages of the drug.

Flupenthixol exhibits a disinhibitory (activating and anti-autistic) effect, and also reduces secondary signs of general mood disorder, which, in turn, helps stimulate patients with depressive symptoms, improves their communication skills and promotes rapid social adaptation .

In medium and small dosages (orally up to 25 mg per day and intramuscularly up to 100 mg once every 14 days), the drug does not have sedative effects . Nonspecific sedative effects may occur when high doses are used. When taken orally in small daily doses (up to 3 mg), antidepressant effectiveness of the drug is observed.

The intramuscular oil solution of flupenthixol is intended for depot injections and is a deposited form of the drug (Fluanxol Depot). The injection solution has a significantly longer duration of action compared to tablets, which is especially important when carrying out continuous antipsychotic treatment of patients who do not comply with all medical prescriptions.

The use of ampoule Fluanxol prevents frequent relapses observed when patients taking the drug orally interrupt therapy on their own. The intramuscular solution can be administered, depending on the pathology, at a frequency of once every 2-4 weeks.

Cmax in the blood is observed 3-6 hours after internal administration of the drug. Bioavailability at 40%.

The active ingredient of the ampoules is cis(Z)-flupenthixol decanoate , after intramuscular injection, amenable to enzymatic cleavage to release cis(Z)-flupenthixol and decanoic acid. In the blood, Cmax of cis(Z)-flupenthixol is observed approximately 7 days after administration.

The apparent Vd is 14.1 l/kg. The connection with plasma proteins is almost complete (99%). If the drug is used by intramuscular injection, Css is achieved after 3 months.

In small quantities, the active ingredient of the ampoules is present in mother's milk and also penetrates the placental barrier .

Metabolic products do not reveal neuroleptic activity.

When taken orally, T1/2 is approximately 35 hours. With intramuscular injections, the concentration of the drug decreases exponentially with T1/2 for about 3 weeks.

The drug is excreted to a greater extent in feces, and to a lesser extent in urine.

An IM dose of Fluanxol 40 mg, with a single administration every 14 days, is pharmacokinetically equivalent to a tableted daily dose of 10 mg, taken daily for 2 weeks.

Fluanxol amp 20mg/ml 1ml N10 (Lundbeck)

The incidence of side effects and their severity are most pronounced at the beginning of treatment and decrease as therapy continues. From the nervous system: drowsiness, dizziness, headache, tremor, akathisia, parkinsonism, hypokinesia, dystonia; uncommon - attention disorders, extrapyramidal disorders (mainly muscle rigidity and hyperkinesis), dyskinesia, amnesia, convulsive disorders, tardive dystonia. From the side of mental activity: insomnia, nervousness, agitation; infrequently - decreased libido, depression, confusion. From the cardiovascular system: infrequently - palpitations, orthostatic hypotension. From the hematopoietic organs: rarely - granulocytopenia, agranulocytosis (more likely between 4 and 10 weeks of treatment), leukopenia, hemolytic anemia. From the organs of vision: disturbance of accommodation, clouding of the cornea and/or lens with possible visual impairment; infrequently - oculogyric crisis. From the digestive system: dry mouth, digestive disorders (including constipation, diarrhea, dyspepsia, nausea), increased salivation, vomiting, cholestatic jaundice (more likely between 2 and 4 weeks of treatment). Metabolic and eating disorders: uncommon - decreased appetite, increased appetite. From the respiratory system: infrequently - shortness of breath. From the endocrine system: dysmenorrhea, gynecomastia, diabetes mellitus, decreased potency, changes in carbohydrate metabolism, hot flashes. From the urinary system: infrequently - urinary retention, painful urination. Allergic reactions: uncommon - itching, dermatitis, skin rash, photosensitivity, increased sweating. Disorders of the musculoskeletal system and connective tissue: infrequently - arthralgia. From the reproductive system: infrequently - erectile dysfunction, galactorrhea. From the body as a whole: weakness, asthenia; infrequently - weight gain. There is evidence of the development of neuroleptic malignant syndrome (NMS). The main symptoms of NMS are hyperthermia, muscle rigidity and impaired consciousness in combination with dysfunction of the autonomic nervous system (labile blood pressure, tachycardia, increased sweating). In addition to immediate cessation of antipsychotic medications, the use of general supportive measures and symptomatic treatment is essential. Patients on long-term treatment may develop tardive dyskinesia. Antiparkinsonian drugs do not eliminate its symptoms and may worsen them. It is recommended to reduce the dose or, if possible, discontinue treatment. For persistent akathisia, benzodiazepines or propranolol may be helpful. There are isolated reports of the development of minor transient changes in liver function test parameters. When taking flupenthixol, the following side effects that occurred when taking other antipsychotics were also recorded: in rare cases, prolongation of the QT interval, ventricular (ventricular) arrhythmia - ventricular fibrillation, ventricular tachycardia, sudden death and the development of paroxysms of ventricular tachycardia (Torsade de Pointes).

Indications for use

When taken orally at a daily dose of up to 3 mg:

depressive states of moderate and mild severity, accompanied by anxiety , lack of initiative and asthenia ;
neurotic disorders of a chronic nature, with apathy , depression and anxiety ;
psychosomatic disorders with asthenic conditions.

When taken orally, a daily dose of 3 mg or more:

schizophrenia-like psychoses and schizophrenia with a dominance of hallucinatory symptoms, thinking disorders , delusions , which are accompanied by autism , anergy , apathy and low mood.

When used as an intramuscular injection:

schizophrenia and other psychotic disorders with autism , anergy , apathy and low mood, accompanied by hallucinations , thinking disorders, delusions .

Contraindications

any conditions accompanied by suppression of consciousness , including due to the use of alcohol , opioid analgesics or barbiturates ;
congenital intolerance to fructose and/or galactose;
deficiency of isomaltase, lactase, sucrase;
impaired absorption of galactose and glucose (for tablets);
vascular collapse;
coma;
age under 18 years;
hypersensitivity to the ingredients of the drug or phenothiazines .

Carefully:

organic pathologies of the brain;
convulsive conditions, epilepsy (possible increase in the frequency of seizures as a result of a decrease in convulsive readiness);
increased risk of stroke ;
liver failure ;
hypomagnesemia , hypokalemia ;
history of cardiovascular diseases (increased risk of low blood pressure ), including bradycardia (less than 50 beats/min), prolongation of the QT interval , recent myocardial infarction , arrhythmia , heart failure (uncompensated);
glaucoma or risk factors for its development;
gastrointestinal ulcer;
alcoholism (possibly increased CNS depression);
leukopenia;
pheochromocytoma;
breathing disorders that are associated with acute infections, emphysema , bronchial asthma ;
Parkinson's disease (exacerbation of extrapyramidal effects);
Reye's syndrome (possible increase in hepatotoxicity);
urinary retention and prostate adenoma with clinical manifestations;
periods of breastfeeding and pregnancy .

Patients with psychomotor agitation are not recommended to use Fluanxol in a daily dose of up to 25 mg, due to the activating effect of small doses of the drug (up to 3 mg per day for oral administration and 10-20 mg once every 14 days for intramuscular injections), which may cause exacerbation of existing symptoms.

Fluanxol tab p/sah obol 1mg N50 (Lundbeck)

Side effects

Nervous system (NS):

headache;
drowsiness;
tremor;
parkinsonism;
akathisia;
hypokinesia;
speech disorders;
dystonia;
depression;
nervousness;
insomnia;
agitation;
dizziness;
extrapyramidal disorders (hyperkinesis, muscle rigidity);
attention disorders;
dyskinesia;
seizure disorders;
amnesia;
aggression;
confusion;
decreased libido;
tardive dystonia.

It must be remembered that when taking antipsychotics , the group of which includes flupentixol , the development of NMS ( neuroleptic malignant syndrome ) was sometimes observed.

The main symptoms of NMS are manifested by hyperthermia , impaired consciousness and muscle rigidity with parallel dysfunction of the autonomic nervous system ( tachycardia , labile blood pressure , increased sweating ). If these symptoms occur, the antipsychotic and symptomatic and supportive treatment should be prescribed.

Long-term therapy with Fluanxol can lead to the development of tardive dyskinesia . The use of antiparkinsonian drugs does not eliminate symptoms, but, on the contrary, can intensify them.

In this case, a dose reduction is indicated until treatment is discontinued.

In case of persistent akathisia , effective drugs are: Propranolol or benzodiazepines .

Feelings of anxiety or transient insomnia may occur especially when previously taking antipsychotics that have a sedative effect .

motility disorders may occur .

These disorders are leveled out by lowering doses and/or prescribing antiparkinsonian drugs, the constant use of which, in order to prevent side effects, is not recommended.

The cardiovascular system:

tachycardia;
orthostatic hypotension ;
ventricular arrhythmia (ventricular tachycardia , ventricular fibrillation , tachycardia of the “pirouette” type, sudden death );
prolongation of the QT interval.

Hematopoietic system:

hemolytic anemia ;
agranulocytosis (most often during the period between 4 and 10 weeks of therapy);
granulocytopenia;
leukopenia.

Organ of vision:

clouding of the lens and/or cornea, with the possibility of visual impairment;
disturbance of accommodation;
accommodation paresis;
oculogyric crisis.

Gastrointestinal system:

digestive disorders ( diarrhea , nausea , dyspepsia , constipation );
dry mouth;
increased salivation ;
vomit;
dysphagia;
cholestatic jaundice (most often during the period between 4 and 10 weeks of therapy);
decreased appetite;
transient minor changes in liver enzymes.

Endocrine system:

gynecomastia;
galactorrhea;
dysmenorrhea;
decreased libido;
weight gain;
impotence;
increased appetite;
carbohydrate metabolism disorders;
tides.

Reproductive system:

erectile disfunction.

Urinary system:

painful urination;
urinary retention.

Musculoskeletal system:

arthralgia.

Allergic manifestations:

increased sweating;
dermatitis;
skin rash and itching ;
photosensitivity.

Local complications:

swelling;
erythema;
abscess;
inflammation.

Other:

asthenia;
weakness.

Fluanxol®

When taking any antipsychotics, there is a possibility of developing neuroleptic malignant syndrome (hyperthermia, muscle rigidity, episodes of loss of consciousness, instability of the autonomic nervous system).

The risk increases with stronger drugs.

Patients with existing organic brain diseases, mental retardation, and opioid and alcohol dependence have a higher incidence of death.

Treatment: Stop taking antipsychotics. Prescribe symptomatic and restorative therapy. The use of dantrolene and bromocriptine is recommended. Symptoms may persist for more than a week after stopping oral antipsychotics and longer when using depot forms.

Like other antipsychotics, flupentixol should be prescribed with caution to patients with organic brain diseases, seizure disorders and severe liver dysfunction.

It is not recommended to prescribe doses up to 25 mg/day to excitable or hyperactive patients, since the activating effect of the drug can lead to a worsening of the patient's condition. If the patient received tranquilizers or antipsychotics that have a sedative effect, they should be withdrawn gradually.

Like other psychotropic drugs, flupenthixol may change the concentration of insulin and glucose in the blood, which may require dose adjustment of hypoglycemic drugs in patients with diabetes.

During long-term therapy, especially at high doses, it is necessary to carry out careful monitoring, periodically assessing the condition of patients in order to decide on the possibility of reducing the maintenance dose.

Like other drugs belonging to the therapeutic class of antipsychotics, flupentixol may cause QT prolongation.

Persistently prolonged QT intervals may increase the risk of malignant arrhythmias. Therefore, flupentixol should be used with caution in patients with hypokalemia, hypomagnesemia and a genetic predisposition to such conditions and in patients with a history of cardiovascular disease, such as QT prolongation, significant bradycardia (<50 beats per minute), recent acute myocardial infarction, decompensated heart failure or arrhythmia. Concomitant use with other antipsychotics should be avoided (see section “Interaction with other drugs”).

Depression is associated with an increased risk of suicidal ideation, self-harm, and suicide (suicidal events). This risk persists until significant remission occurs. Since improvement may not be observed during the first few weeks of therapy or even longer, patients should be closely monitored until their condition improves.

General clinical practice shows that in the early stages of recovery the risk of suicide may increase.

Other psychiatric conditions for which flupenthixol is prescribed may also be associated with an increased risk of suicidal events. In addition, these conditions may be a comorbidity in relation to a depressive episode. When treating patients with other mental disorders, the same precautions should be taken as when treating patients with a depressive episode.

Patients with a history of suicidal behavior or patients with a significant level of suicidal thoughts before treatment are at greater risk for suicidal ideation or suicide attempts and should be closely monitored during treatment. A meta-analysis of placebo-controlled clinical trials of antidepressants in adult patients with mental disorders found that there is an increased risk of suicidal behavior in patients under 25 years of age when taking antidepressants compared with placebo. Drug treatment of these patients, and in particular those at high risk for suicide, should be accompanied by careful monitoring, especially early in treatment and during dose changes. Patients (and caregivers) should be warned to monitor for any signs of clinical worsening, suicidal behavior or ideation, or unusual changes in behavior, and to seek immediate medical advice if these symptoms occur.

Cases of venous thromboembolism have been reported while taking antipsychotics. Due to the fact that patients being treated with antipsychotics are often at risk for developing venous thromboembolism, risk factors for developing venous thromboembolism should be determined before and during treatment with flupenthixol and precautions should be taken.

Elderly patients

Cerebrovascular adverse reactions

In randomized, placebo-controlled clinical trials of certain atypical antipsychotics in patients with dementia, a 3-fold increase in the risk of cerebrovascular adverse reactions was observed. The mechanism for this increased risk is unknown. An increased risk cannot be ruled out when using other antipsychotics in

other groups of patients. Flupenthixol should be used with caution in patients at risk of stroke.

Increased mortality in older patients with dementia

Data from two large observational studies showed that older patients with dementia who took antipsychotic drugs had a small increased risk of death compared with patients not taking antipsychotic drugs. There is no sufficient data to accurately assess the magnitude of the risk and the reasons for its increase. Fluanxol is not registered for the treatment of behavioral disorders in patients with dementia.

Excipients

The tablets contain lactose monohydrate. Patients with rare hereditary galactose intolerance, lactase deficiency or impaired absorption of glucose and galactose should not take this drug. 5 mg tablets contain the dye Sunset Yellow Aluminum Lacquer (E110) (FD&C, FCF), which may cause allergic reactions.

Fluanxol tablets, instructions for use (Method and dosage)

Instructions for use of Fluanxol recommends taking it orally (orally) with water.

When taking tablets in a daily dose of up to 3 mg:

For the treatment of moderate and mild depressive states of anxiety , lack of initiative and asthenia ; chronic neurotic disorders apathy , depression and anxiety; For psychosomatic disorders with asthenia , Fluanxol is prescribed in an initial daily dose of 1 mg once in the morning, or in a half dose (500 mcg) twice a day.

In the absence of positive therapeutic dynamics over 7 days, you can increase the daily dose to 2 mg. The dosage of tablets is from 2 mg to 3 mg, must be taken in several doses. For elderly patients, a daily dose of 0.5 to 1.5 mg is recommended.

As a rule, the therapeutic effect of Fluanxol manifests itself within 2-3 days. If the maximum possible daily dosage of 3 mg tablets for a week is ineffective, therapy is discontinued.

When taking tablets in a daily dose of 3 mg or higher:

For the treatment of psychotic disorders, the dose of Fluanxol is selected individually, depending on the general condition of the patient.

At the beginning of therapy, it is recommended to take low doses of the drug, subsequently moving, depending on the individual response of the patient, to taking higher doses, until the optimal effective dosage is determined.

Therapy begins with a daily dose of 3 to 15 mg, depending on the severity of the condition. This dose must be divided into 2-3 doses. If necessary, this dosage can be increased to 20-30 mg.

The maximum permissible dose of tablets per day is 40 mg. Maintenance therapy is carried out in a daily dose of 5-20 mg.

When using IM injection solution:

The injection solution is indicated for intramuscular injection deep into the outer upper quadrant of one of the buttocks. Injecting the solution into other muscles is not advisable. If it is necessary to administer more than 2 ml of solution, it is recommended to make 2 injections.

The dosage of ampoules of 20 mg/ml is usually 1-2 ml (20-40 mg), administered once every 2-4 weeks. Some patients require higher doses of the drug or shorter intervals between doses.

In case of acute relapse or exacerbation of the disease, it may be necessary to administer high doses of the solution, up to 400 mg once, with a frequency of 14 or even 7 days.

When switching from the oral form of Fluanxol to intramuscular injection:

When switching from taking tablets to using intramuscular injections, it is necessary to calculate the daily dose of the solution.

To do this, the daily oral dose of tablets (mg) is multiplied by four, which will constitute a single dose of intramuscular solution (mg), administered once every 2 weeks.

In parallel, for 7 days after the 1st injection, it is necessary to continue taking the tablets, but in a smaller dose.

Subsequently, the dosage of injections and the intervals between them are established based on the individual clinical effect. The one-time maximum dose of the intramuscular solution is 400 mg with an interval of 7 days.

Patients switching to Fluanxol IM solution from other drugs in depot forms should use it in the following ratios: flupenthixol decanoate at a dose of 40 mg corresponds to 200 mg zuclopenthixol decanoate , 25 mg fluphenazine decanoate or 50 mg haloperidol decanoate .

Fluanxol 1 mg 50 pcs. film-coated tablets

pharmachologic effect

Blocks dopamine receptors in the brain.

Composition and release form Fluanxol 1 mg 50 pcs. film-coated tablets

1 tablet contains flupenthixol hydrochloride 0.5, 1 or 5 mg; in a plastic bottle 50 or 100 pcs. respectively.

Directions for use and doses

Orally, for depressive and anxiety disorders: the initial dose is 1 mg once a day, in the morning, or 0.5 mg 2 times a day. If there is no satisfactory effect, the dose can be increased after 1 week. The daily dose of 2-3 mg is divided into several doses. If there is no effect within 7 days when taken at the maximum dose (3 mg), therapy is canceled. Psychotic disorders: initial dose: 3-15 mg/day in 2-3 doses. If necessary, increase the dose to 40 mg/day. Acute and chronic psychoses: 40-150 mg/day. The daily dose depends on the severity of the disease, the degree of its resistance to therapy, the age and body weight of the patient. The frequency of administration is greatest at the beginning of therapy, usually 4 times a day, then it is reduced to 1-3 times. Maintenance dose is 3-20 mg 1 time per day, in the morning. Drops can be mixed with water, orange or apple juice. IM (in the form of flupenthixol decanoate), the dose varies from 20 to 200 mg at intervals of 2-4 weeks. Depot injection solution (20 mg/ml) - 20-40 mg (1-2 ml) every 2-4 weeks. Depot injection solution (100 mg/ml) - 50-200 mg (0.5-2 ml) every 2-4 weeks. When switching from oral forms to maintenance treatment with depot injections, the following rule should be followed: single dose (mg) for intramuscular administration every 2 weeks = daily dose (mg) for oral administration x 4. In the first week after the injection, oral administration should be continued at a lower dose. A depot injection dose of 40 mg once every 2 weeks is equivalent to daily oral administration at a dose of 10 mg/day for 2 weeks. Maintenance dose - 20-40 mg every 2-4 weeks, if necessary - 50-200 mg every 2-4 weeks. In case of exacerbation, it is possible to increase the dose to 400 mg simultaneously at intervals of 2-1 weeks; in case of remission, the dose is reduced to 20 -200 mg every 2-4 weeks.

Indications for use Fluanxol 1 mg 50 pcs. film-coated tablets

Large doses (3 mg or more): psychoses (including acute and chronic, with a predominance of hallucinations, paranoid delusions and thinking disorders, accompanied by apathy, anergy and autism, schizophrenia). Small doses (up to 3 mg): anxiety disorders (including acute and situationally determined), stressful conditions (in which a sedative-hypnotic effect is not required), asthenodepressive syndrome, depression with lack of initiative, neuroses (with anxiety, depression and inertia), psychosomatic disorders (with asthenic reactions) ,alcohol withdrawal syndrome.

Contraindications

Hypersensitivity (including to phenothiazines), pathological changes in the blood, suppression of bone marrow function, collapse, central nervous system depression or coma caused by taking drugs, pregnancy, lactation, childhood. With caution. Alcoholism (CNS depression may increase) , cardiovascular diseases (risk of transient decrease in blood pressure), glaucoma (including predisposition to it), peptic ulcer of the stomach and duodenum, respiratory failure associated with acute infectious diseases, asthma or emphysema, urinary retention, liver failure , Parkinson's disease (increased extrapyramidal effects), prostatic hyperplasia with clinical manifestations (risk of urinary retention), Reye's syndrome (increased risk of hepatotoxicity), epilepsy (as a result of a decrease in the convulsive threshold, an increase in seizures is possible).

Application of Fluanxol 1 mg 50 pcs. film-coated tablets during pregnancy and breastfeeding

Contraindicated during pregnancy and lactation, as well as for children.

special instructions

Prescribe with caution for convulsive syndrome, chronic hepatitis, cardiovascular diseases; persons driving a car or other machinery (especially at the beginning of treatment). When pre-treatment with antipsychotics or tranquilizers (with sedative effects), their use should be discontinued gradually. With long-term therapy, especially in large doses, careful monitoring of the patient's condition is necessary.

Side effects Fluanxol 1 mg 50 pcs. film-coated tablets

From the nervous system: increased fatigue, dizziness, psychomotor retardation, mild extrapyramidal hypokinetic-hypertensive syndrome, akathisia (within the first 6 hours after administration), dystonic reactions, persistent tardive dyskinesia, rare malignant neuroleptic syndrome, tardive dystonia. From the cardiovascular system : orthostatic hypotension, tachycardia, while taking other thioxanthenes, changes in the Q and T waves on the ECG are described. From the sensory organs: clouding of the cornea and/or lens with possible visual impairment, accommodation paresis. From the digestive system: dry mouth, constipation , cholestatic jaundice (more likely between 2-4 weeks of treatment). From the hematopoietic organs: rarely, agranulocytosis (more likely between 4-10 weeks of treatment), leukopenia, hemolytic anemia. From the endocrine system: dysmenorrhea, galactorrhea, gynecomastia, diabetes diabetes, decreased potency and/or libido, increased appetite, changes in carbohydrate metabolism, weight gain, increased sweating. From the urinary system: urinary retention. Allergic reactions: skin rash, dermatitis, photosensitivity. Other: flushing syndrome.

Drug interactions

Enhances (in high doses) the effect of alcohol, barbiturates and other central nervous system depressants, and reduces the effect of levodopa and other adrenergic substances. Weakens the hypotensive effect of guanethidine and its analogues. The risk of developing extrapyramidal disorders is increased by metoclopramide and piperazine.

Overdose

In case of an overdose of Fluanxol, the following may occur: drowsiness , hypo- or hyperthermia, shock , convulsions , extrapyramidal disorders , coma .

When used in combination with drugs that affect cardiac activity, the following are possible: changes in the ECG , ventricular arrhythmias , prolongation of the QT interval, cardiac arrest .

Supportive and symptomatic treatment is recommended. In case of oral administration of high doses of the drug, the stomach is washed and sorbents .

Measures should also be taken to maintain breathing and cardiovascular activity. Taking epinephrine ( Adrenaline ) is not recommended, as it can cause a decrease in blood pressure .

Seizures are relieved with Diazepam , and Biperiden .

Side effects

The main spectrum of side effects associated with Fluanxol therapy is neuroleptic syndrome. Its main symptoms are extrapyramidal disorders, characterized by hyper- or hypokinetic disorders.

Hypokinetic side effects are represented by drug-induced parkinsonism, which manifests itself in the form of muscle rigidity and stiffness, slowness of speech and speed of reactions, and drowsiness. Hyperkinetic disorders include tremor, increased excitability, hyperthermia, and sweating.

In combination with extrapyramidal disorders, symptoms of akathisia may be observed - lack of perseverance, “restless legs syndrome”, sleep disorders, increased anxiety. Disturbances in the functioning of the autonomic nervous system cause the development of orthostatic hypotension, weight gain, pathological changes in appetite, problems with stool, and increased sweating.

Anticholinergic side effects such as visual disturbances and dysuria are sometimes observed. Possible disturbances in the functioning of the heart and blood vessels with characteristic changes on the ECG in the form of brady- or tachycardia, an increase in the Q-T interval. Some patients while taking Fluanxol develop skin reactions - pathological pigmentation, dermatoses, allergic reactions such as urticaria.

Interaction

When using Fluanxol, it is possible to enhance the sedative effects of barbiturates , ethanol and other drugs that have a depressant effect on the central nervous system.

The drug should not be prescribed in parallel with Guanethidine and drugs with similar effects, since Fluanxol may weaken their antihypertensive effectiveness.

Flupenthixol together with tricyclic antidepressants inhibit each other's metabolism.

Combined use with lithium preparations may increase neurotoxicity .

Fluanxol may reduce the effect of Levodopa and adrenergic drugs .

The risk of extrapyramidal disorders increases when Fluanxol is used together with Piperazine and Metoclopramide .

Due to a possible increase in the QT interval, it is not recommended to prescribe flupentixol simultaneously with drugs that have a similar effect.

Among these drugs are: antiarrhythmic drugs of classes IA and III ( Dofetilide , Amiodarone , Quinidine , Sotalol ); antipsychotic drugs ( Thioridazine ); macrolides ( Erythromycin ); quinolones ( Moxifloxacin , Gatifloxacin ); antihistamines ( Astemizole , Terfenadine ); lithium preparations; cisapride .

When used in parallel with drugs that cause electrolyte imbalance ( thiazide-like and thiazide diuretics ), as well as drugs that increase the content of flupenthixol in the blood, an increase in the QT interval and the development of life-threatening arrhythmias

Fluanxol IM solution cannot be mixed with deposited forms based on sesame oil due to a significant effect on their joint pharmacokinetics.

Pathogenesis of complications development

Fluanxol, as a thioxanthene derivative, has a wide spectrum of action, directly affecting individual structures of the central nervous system. The complexity of using the drug leads to a specific form of addiction to it. The drug does not cause drug dependence, but during and after stopping its use, side effects and Fluanxol withdrawal syndrome may occur.

The mechanism of development of such reactions is determined by the peculiarities of the functioning of the central nervous system. The complications are based on changes in the sensitivity of the corresponding brain structures to the effects of chemical compounds. The absence of the usual inhibitory effect on synapses or an inadequate response of cells to the action of the drug leads to a deterioration in the patient’s well-being. This condition is accompanied by neurological, mental and other symptoms.

special instructions

The use of Fluanxol in parallel treatment of diabetes mellitus may require adjustment of insulin .

With previous therapy with tranquilizers and antipsychotics with sedative effects, their use should be stopped gradually.

Long-term therapy with Fluanxol, especially in high doses, requires careful monitoring and assessment of the patient's condition for timely adjustment of maintenance doses.

You should refrain from driving vehicles, as well as precise and dangerous work.

Instructions for use FLUANXOL

When treated with any neuroleptics, there is a possibility of developing neuroleptic malignant syndrome (NMS). The main symptoms of NMS are hyperthermia, muscle rigidity and impaired consciousness in combination with dysfunction of the autonomic nervous system (labile blood pressure, tachycardia, increased sweating). In addition to immediate cessation of antipsychotic medication, the use of general supportive measures and symptomatic treatment is essential.

With concomitant diabetes mellitus, the administration of Fluanxol may change the concentration of insulin and glucose in the blood, which may require dose adjustment of hypoglycemic drugs.

If the patient was previously treated with antipsychotics or tranquilizers with a sedative effect, then their use should be stopped gradually.

During long-term therapy, especially with maximum daily doses, it is necessary to carry out careful monitoring, periodically assessing the condition of patients in order to decide on the possibility of reducing the maintenance dose.

Like other drugs belonging to the therapeutic class of antipsychotics, Fluanxol may cause QT prolongation. Persistently prolonged QT intervals may increase the risk of malignant arrhythmias.

Cases of venous thromboembolism have been reported while taking antipsychotics. Due to the fact that patients being treated with antipsychotics are often at risk of developing venous thromboembolism, before and during treatment with Fluanxol, it is necessary to determine risk factors for the development of venous thromboembolism and take precautions.

An increased risk cannot be ruled out when using other antipsychotics in other groups of patients. Fluanxol should be used with caution in patients at risk of stroke.

Fluanxol is not registered for the treatment of behavioral disorders in elderly patients with dementia.

When drinking alcohol during treatment with flupenthixol, the inhibitory effect on the central nervous system may be enhanced.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

During pregnancy and lactation

The use of Fluanxol during pregnancy and breastfeeding is possible only in cases where the expected benefit of treatment for the mother far outweighs the possible risk to the fetus.

Cases have been described of the use of antipsychotics during childbirth or in the third trimester of pregnancy , which led to signs of intoxication ( tremor , lethargy , excessive excitability ) in the newborn. In addition, they had a low Apgar score.

If there is a clinical need for the use of Fluanxol during lactation , you should monitor the health of the newborn, especially in the first month after birth, or stop breastfeeding.

Fluanxol price, where to buy

In Russian pharmacies the average price of Fluanxol is:

tablets 0.5 mg No. 50 – 330 rubles;
tablets 1 mg No. 50 – 480 rubles;
tablets 5 mg No. 100 – 1100 rubles;
ampoules 20 mg/ml 1 ml No. 10 – 2000 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

ZdravCity

Fluanxol solution in / m oil.
20 mg/ml 1 ml 10 pcs. Lundbeck 1011 rub. order
Fluanxol tab. p/o captivity. 1mg №50H.Lundbeck A/S
417 RUR order

Pharmacy Dialogue

Fluanxol (tablet p/o 1 mg No. 50) Lundbeck
RUB 381 order
Fluanxol (tablet p/o 5 mg No. 100) Lundbeck
RUR 1,028 order

Pharmacy24

Fluanxol 0.5 mg No. 100 tablets H. Lundbeck A/S, Denmark
300 UAH. order
Fluanxol depot 20 mg 1 ml No. 10 injection solution H. Lundbeck A/S, Denmark
858 UAH order
Fluanxol 1 mg No. 100 tablets H. Lundbeck A/S, Denmark
261 UAH. order