Formulary
Flupentixol: Indications, Dosing, Side Effects and Interactions
Flupentixol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 5 min read
Flupentixol: Indications, Dosing, Side Effects and Interactions
Flupentixol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Schizophrenia and other psychoses, particularly with apathy and withdrawal but not mania or psychomotor hyperactivity**
- **Adult** (By Mouth): Initially 3-9 mg twice daily, adjusted according to response, for debilitated patients, use elderly dose; maximum 18 mg per day.
- **Elderly** (By Mouth): Initially 0.75-4.5 mg twice daily, adjusted according to response.
**Depressive illness**
- **Adult** (By Mouth): Initially 1 mg once daily, dose to be taken in the morning, increased if necessary to 2 mg after 1 week, doses above 2 mg to be given in divided doses, last dose to be taken before 4 pm; discontinue if no response after 1 week at maximum dosage; maximum 3 mg per day.
- **Elderly** (By Mouth): Initially 500 micrograms daily, dose to be taken in the morning, then increased if necessary to 1 mg after 1 week, doses above 1 mg to be given in divided doses, last dose to be taken before 4 pm; discontinue if no response after 1 week at maximum dosage; maximum 1.5 mg per day.
Cautions
For all antipsychotic drugs Blood dyscrasias; cardiovascular disease; conditions predisposing to seizures; depression; diabetes (may raise blood glucose); epilepsy; history of jaundice; myasthenia gravis; Parkinson's disease (may be exacerbated); photosensitisation (may occur with higher dosages); prostatic hypertrophy; severe respiratory disease; susceptibility to angle-closure glaucoma Cautions, further information Cardiovascular disease An ECG may be required, particularly if physical examination identifies cardiovascular risk factors, personal history of cardiovascular disease, or if the patient is being admitted as an inpatient. Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: for all antipsychotics (other than quetiapine and clozapine) in patients with parkinsonism or Lewy Body Disease (risk of severe extrapyramidal symptoms) in behavioural and psychological symptoms of dementia (BPSD), unless symptoms are severe and other non-pharmacological treatments have failed (increased risk of stroke) for use as a hypnotic, unless sleep disorder is due to psychosis or dementia (risk of confusion, hypotension, extrapyramidal side-effects, and falls) in patients prone to falls (may cause gait dyspraxia, parkinsonism) if prescribed a phenothiazine (other than prochlorperazine for nausea, vomiting, or vertigo; chlorpromazine for relief of persistent hiccups; levomepromazine as an antiemetic in palliative care) as first-line treatment (sedative, significant antimuscarinic (anticholinergic) toxicity in older people, and safer and more efficacious alternatives exist) if prescribed an antipsychotic drug with moderate or marked antimuscarinic effects (e.g. chlorpromazine, clozapine, flupenthixol, fluphenazine, pipothiazine, promazine, and zuclopenthixol) in patients with a history of prostatism or urinary retention (high risk of urinary retention) Cautions For flupentixol Cardiac disorders; cardiovascular disease; cerebral arteriosclerosis; elderly; hyperthyroidism; hypothyroidism; parkinsonism; phaeochromocytoma; QT-interval prolongation; senile confusional states
Contraindications
Circulatory collapse; CNS depression; comatose states; excitable patients; impaired consciousness; overactive patients
Side effects
For all antipsychotic drugs Common or very common Agitation; amenorrhoea; arrhythmias; constipation; dizziness; drowsiness; dry mouth; erectile dysfunction; fatigue; galactorrhoea; gynaecomastia; hyperglycaemia; hyperprolactinaemia; hypersalivation; hypotension (dose-related); insomnia; leucopenia; movement disorders; muscle rigidity; neutropenia; parkinsonism; postural hypotension (dose-related); QT interval prolongation; rash; seizure; tremor; urinary retention; vomiting; weight increased Uncommon Agranulocytosis; confusion; neuroleptic malignant syndrome (discontinue-potentially fatal) Rare or very rare Sudden death; withdrawal syndrome neonatal Side-effects, further information For depot antipsychotics-side-effects may persist until the drug has been cleared from its depot site. Overdose Phenothiazines cause less depression of consciousness and respiration than other sedatives. Hypotension, hypothermia, sinus tachycardia, and arrhythmias may complicate poisoning. For details on the management of poisoning see Antipsychotics under Emergency treatment of poisoning . Side-effects For flupentixol Common or very common Appetite abnormal; asthenia; concentration impaired; depression; diarrhoea; dyspnoea; gastrointestinal discomfort; headache; hyperhidrosis; myalgia; nervousness; palpitations; sexual dysfunction; skin reactions; urinary disorder; vision disorders Uncommon Flatulence; hot flush; nausea; oculogyration; photosensitivity reaction; speech disorder Rare or very rare Glucose tolerance impaired; jaundice; thrombocytopenia Frequency not known Suicidal behaviours; venous thromboembolism
Interactions
**Other interactions (4):**
- In common with other antipsychotics, flupentixol enhances the response to alcohol the effects of barbiturates and other CNS depressants.
- Flupentixol may potentiate the effects of general anaesthetics and anticoagulants and prolong the action of neuromuscular blocking agents.
- Drugs known to cause electrolyte disturbances such as thiazide diuretics (hypokalaemia) and drugs known to increase the plasma concentration of flupentixol should also be used with caution as they...
- Interactions causing neurotoxicity Neuroleptics (particularly haloperidol at higher dosages), flupentixol, risperidone, diazepam, thioridazine, fluphenazin, chlorpromazine and clozapine may lead...
Pregnancy
For all antipsychotic drugs Extrapyramidal effects and withdrawal syndrome have been reported occasionally in the neonate when antipsychotic drugs are taken during the third trimester of pregnancy. Following maternal use of antipsychotic drugs in the third trimester, neonates should be monitored for symptoms including agitation, hypertonia, hypotonia, tremor, drowsiness, feeding problems, and respiratory distress. Pregnancy For flupentixol Avoid unless potential benefit outweighs risk.
Breast feeding
For all antipsychotic drugs There is limited information available on the short- and long-term effects of antipsychotic drugs on the breast-fed infant. Animal studies indicate possible adverse effects of antipsychotic medicines on the developing nervous system. Chronic treatment with antipsychotic drugs whilst breast-feeding should be avoided unless absolutely necessary. Phenothiazine derivatives are sometimes used in breast-feeding women for short-term treatment of nausea and vomiting. Breast feeding For flupentixol Present in breast milk-avoid.
Hepatic impairment
Manufacturer advises caution-monitor serum drug concentration.
Renal impairment
Caution in renal failure (increased risk of cerebral sensitivity). M
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Flupentixol in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

