Stela

Indications

Trifluoperazine is an antipsychotic medicine used to treat schizophrenia and other psychotic illnesses, in which a person may hear voices, hold false beliefs or think in a confused way. In low doses it is sometimes used for a short time to treat severe anxiety or agitation, and for severe nausea and vomiting when other treatments are not suitable. It is prescription only.

How It Works

Trifluoperazine belongs to the phenothiazine group of older (typical) antipsychotics. It blocks dopamine receptors in the brain. Dopamine is a chemical messenger, and too much dopamine activity in certain brain areas is linked to psychotic symptoms. By reducing this activity, Trifluoperazine calms agitation and reduces hallucinations and false beliefs. Blocking dopamine in the vomiting centre of the brain also reduces nausea.

Dosage and Administration

Take exactly as prescribed. The dose depends on the condition, age and response, and your doctor will start low and adjust it step by step. For anxiety or nausea, low doses are used for short periods only. Older people usually need smaller doses. Swallow tablets with water. Do not stop suddenly; your doctor will reduce the dose gradually.

Interactions

Trifluoperazine adds to the sleepiness caused by alcohol, sleeping pills, Opioid painkillers, antihistamines and other sedating medicines. It can reduce the effect of Levodopa and other Parkinson medicines. Taking it with medicines that affect heart rhythm, such as Amiodarone, Sotalol, some antibiotics and other antipsychotics, may increase the risk of rhythm problems. Antacids can reduce its absorption, so take them at least 2 hours apart. Lithium together with it may increase side effects on the nervous system. It may increase the effect of blood pressure medicines.

Contraindications

• Allergy to Trifluoperazine or other phenothiazines.
• Coma or severe depression of brain function, for example from alcohol or sedatives.
• Bone marrow disorders or serious blood disorders.
• Severe liver disease.

Side Effects

Common effects include drowsiness, dizziness, dry mouth, blurred vision, constipation and weight gain. Movement-related effects are fairly common: stiffness, shaking, restlessness, slow movement and sudden muscle spasms of the face, neck or eyes. Long-term use can cause tardive dyskinesia, uncontrolled movements of the mouth, tongue or face that may be permanent. Other effects include low blood pressure on standing, increased sensitivity to sunlight, menstrual changes and breast swelling or milk discharge.

Get urgent medical help for high fever with stiff muscles, sweating and confusion (neuroleptic malignant syndrome), fainting or fast irregular heartbeat, yellow skin or eyes, sore throat with fever or mouth ulcers (possible low white blood cells), sudden spasm that affects breathing or swallowing, or an allergic reaction.

Pregnancy and Lactation

Use in pregnancy only if clearly needed and prescribed by a doctor; use in late pregnancy can cause movement problems or withdrawal symptoms in the newborn. It passes into breast milk; breastfeeding is generally not advised unless the doctor approves.

Precautions and Warnings

• Older people with dementia have a higher risk of stroke and death with antipsychotics.
• Use with care in heart disease, epilepsy, Parkinson disease, glaucoma, enlarged prostate, diabetes and liver or kidney problems.
• It may cause drowsiness and slow reactions; do not drive or use machines if affected.
• Avoid alcohol. Avoid strong sun and overheating.
• Report any unusual movements to your doctor early.

Overdose

Overdose can cause deep sleepiness, severe stiffness or muscle spasms, low blood pressure, irregular heartbeat, fits and coma. Get emergency medical help at once.

Therapeutic Class

Typical antipsychotic, phenothiazine.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.