Formulary
Pericyazine: Indications, Dosing, Side Effects and Interactions
Pericyazine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 5 min read
Pericyazine: Indications, Dosing, Side Effects and Interactions
Pericyazine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Schizophrenia,Psychoses**
- **Adult** (By Mouth): Initially 75 mg daily in divided doses, then increased in steps of 25 mg every week, adjusted according to response; maximum 300 mg per day.
- **Elderly** (By Mouth): Initially 15-30 mg daily in divided doses, then increased in steps of 25 mg every week, adjusted according to response; maximum 300 mg per day.
**Short-term adjunctive management of severe anxiety, psychomotor agitation, and violent or dangerously impulsive behaviour**
- **Adult** (By Mouth): Initially 15-30 mg daily in 2 divided doses, adjusted according to response, larger dose to be taken at bedtime.
- **Elderly** (By Mouth): Initially 5-10 mg daily in 2 divided doses, adjusted according to response, larger dose to be taken at bedtime.
**Schizophrenia (under expert supervision), Psychoses (severe mental or behavioural disorders only) (under expert supervision) for pericyazine**
- **Child 1-11 years** (By mouth): Initially 500 micrograms daily for 10-kg child, increased by 1 mg for each additional 5 kg; dose may be gradually increased according to response but maintenance should not exceed twice initial dose; maximum 10 mg per day.
- **Child 12-17 years** (By mouth): Initially 25 mg 3 times a day, increased in steps of 25 mg every week, adjusted according to response, increased if necessary up to 100 mg 3 times a day, total daily dose may alternatively be given in 2 divided doses.
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 pericyazine Hypothyroidism; susceptibility to QT interval prolongation
Contraindications
CNS depression; comatose states; phaeochromocytoma
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 pericyazine Frequency not known Atrioventricular block; cardiac arrest; consciousness impaired; contact dermatitis; glucose tolerance impaired; hepatic disorders; hyperthermia; nasal congestion; priapism; respiratory depression
Interactions
**Other interactions (20):**
- Contra-indicated drug combinations: Antiparkinsonism dopaminergic agonists agents (amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribedil, pramiprexole,...
- Alcohol: Intensification of the sedative effects of neuroleptics.
- Avoid consumption of alcoholic beverages and medications containing alcohol.
- Levodopa: Reciprocal antagonism between levodopa and neuroleptics.
- Lithium (high doses of neuroleptics): Concomitant use might increase the risk of QT prolongation and the risk of the appearance of neuropsychiatric signs suggestive of neuroleptic malignant syndrome...
- Regular clinical and biological monitoring of serum (lithium), especially when the combination is initiated.
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.
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.
Hepatic impairment
Can precipitate coma; phenothiazines are hepatotoxic.
Renal impairment
Use with caution (risk of accumulation). M
Medicinal forms
Solution,Tablet,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.
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