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Zuclopenthixol Metabolization

Zuclopenthixol is a high potency antipsychotic neuroleptic with an intense sedative effect. It blocks dopaminergic and serotonergic receptors. It is used to treat chronic and subchronic schizophrenia.

CAUTIONS

In liver failure adjust doses if necessary and determine serum levels if possible, especially if liver disease is advanced.

Precautions should be taken in cases of cerebral organ disease, parkinsonism, convulsive disorders, advanced respiratory disease, pheochromocytoma, hypothyroidism, thyrotoxicosis, myasthenia gravis, prostatic hypertrophy.

Extreme caution in patients with cardiovascular disease and / or arrhythmias. Risk of cardiac interval lengthening QT. Caution should be exercised in patients with hypokalemia, hypomagnesemia, genetic predisposition, history of cardiovascular disorder (QT elongation, bradycardia with less than 50 beats per minute, recent acute myocardial infarction, uncompensated heart failure, arrhythmia).

Use caution in prescribing in elderly patients at risk of hypothermia, personal or family history of angle-closure glaucoma.

Monitor patients on long-term treatment.

Zuclopenthixol can modify the response to insulin and glucose, adjust antidiabetic treatment. Caution when combining long-acting depot forms with drugs with myelosuppressive potential.

SIDE EFFECTS

Drowsiness, akathisia, hyperaemia and hypokinesia, dry mouth, dyskinesia, tremor, dystonia, hypertonia, headache, paraesthesia, attention disorder, amnesia, gait disturbance, eye accommodation disorder, abnormal vision, vertigo, tachycardia, palpitations, nasal congestion, dyspnea, salivary hypersecretion, constipation, vomiting, dyspepsia, diarrhea, urinary retention, urinary retention, polyuria, hyperhidrosis, pruritus, myalgia, increased appetite and weight, asthenia, fatigue, discomfort, pain, insomnia, depression, anxiety , nervousness, abnormal dreams, agitation and decreased libido.

PHARMACOLOGIC INTERACTIONS

Zuclopenthixol potentiates the sedative effect of alcohol, barbiturates and other central nervous system (CNS) depressants.

Risk of neurotoxicity and increased QT interval with lithium which is recommended to avoid.

Mutual inhibition of metabolism with tricyclic antidepressants.

Zuclopenthixol intake decreases the effect of levodopa and adrenergic.

Risk of extrapyramidal reaction with metoclopramide and piperazine.

Increased risk of increased QT interval with class Ia and III antiarrhythmics (quinidine, amiodarone, sotalol, dofetilide), thioridazine, erythromycin, terfenadine, astemizole, moxifloxacin, gatifloxacin and cisapride, which are recommended to avoid.

Increased risk of electrolyte disturbance with thiazide diuretics.

BRAND NAME

  • Clopixol ®

Gene or region studied

  • CYP2D6
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