Trifluoperazine

DEA Class;  Rx

Common Brand Names; Stelazine

Hypersensitivity to phenothiazines or excipients

Comatose or greatly depressed states due to central nervous system depressants, existing blood dyscrasias, bone marrow depression, and preexisting liver damage

• EPS (60%; muscle stiffness, dystonia, parkinsonism, tardive dyskinesia, akathisia)
• NMS (infrequent but serious)
• Sedation
• Anticholinergic effects
• Weight gain
• Oligomenorrhea/amenorrhea
• Erectile dysfunction
• Insomnia
• Restlessness
• Anxiety
• Euphoria
• Agitation
• Depression
• Weakness
• Headache
• Cerebral edema
• Poikilothermia
• Orthostatic hypotension
• Tachycardia
• Dizziness
• Lens opacities (prolonged use)Anorexia
• Dyspepsia
• Constipation
• Ileus
• Blood dyscrasia
• ECG changes
• Photosensitivity
• Pruritis
• Diarrhea
• Galactorrhea
• Ejaculatory d/o
• Seizure (rare)
• Priapism (rare)
• Cholestatic jaundice (rare)

Thrombocytopenia and anemia reported in patients receiving therapy; agranulocytosis and pancytopenia also reported; warn patients to report sudden appearance of sore throat or other signs of infection; if white blood cell and differential counts indicate cellular depression, stop treatment and start antibiotic and other suitable therapy

Jaundice of cholestatic type of hepatitis or liver damage reported; if fever with grippe-like symptoms occurs, appropriate liver studies should be conducted; if tests indicate an abnormality, stop treatment

One result of therapy may be an increase in mental and physical activity; for example, a few patients with angina pectoris have complained of increased pain while taking the drug; patients with angina should be observed carefully and, if an unfavorable response noted, the drug should be withdrawn

Because hypotension has occurred, large doses and parenteral administration should be avoided in patients with impaired cardiovascular systems; to minimize occurrence of hypotension after injection, keep patient lying down and observe for at least 1/2 hour; if hypotension occurs from parenteral or oral dosing, place patient in head-low position with legs raised

If a vasoconstrictor is required, norepinephrine bitartrate and phenylephrine hydrochloride are suitable; other pressor agents, including epinephrine, should not be used as they may cause a paradoxical further lowering of blood pressure

Since certain phenothiazines reported to produce retinopathy, the drug should be discontinued if ophthalmoscopic examination or visual field studies should demonstrate retinal changes; an antiemetic action of this drug may mask signs and symptoms of toxicity or overdosage of other drugs and may obscure diagnosis and treatment of other conditions such as intestinal obstruction, brain tumor, and Reye’s syndrome

Safety for use during pregnancy not established; not recommended that the drug be given to pregnant patients except when, in judgment of physician, it is essential

There is evidence that phenothiazines are excreted in breast milk of nursing mothers; because of potential for serious adverse reactions in nursing infants from this drug, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother