Zuclopenthixol (Dosage)
Zuclopenthixol is a highly potent antipsychotic neuroleptic with a strong sedative effect. It blocks dopaminergic and serotonergic receptors. It is used to treat chronic and subchronic schizophrenia.
PRECAUTIONS
In hepatic insufficiency adjust dose if necessary and determine serum levels if possible, especially if hepatopathy is advanced.
Caution should be exercised in cases of organic brain disease, Parkinson's disease, convulsive disorders, advanced respiratory disease, pheochromocytoma, hypothyroidism, thyrotoxicosis, myasthenia gravis, prostatic hypertrophy.
Caution in patients with cardiovascular disease and/or arrhythmias. Risk of lengthening of the cardiac QT interval. Use caution in patients with hypokalemia, hypomagnesemia, genetic predisposition, history of cardiovascular disorder (QT prolongation, bradycardia with less than 50 beats per minute, recent acute myocardial infarction, uncompensated heart failure, arrhythmia).
Use caution in prescribing in elderly at risk of hypothermia, personal or family history of angle-closure glaucoma.
Monitor patients on long-term treatment.
Zuclopenthixol may modify insulin and glucose response, adjust antidiabetic treatment. Caution when combining long-acting "depot" forms with drugs with myelosuppressive potential.
CONTRAINDICATIONS
Hypersensitivity to zuclopenthixol or medium chain triglycerides.
Circulatory failure, circulatory collapse, or decreased level of consciousness, regardless of cause (including alcohol, barbiturate or opiate intoxication), and coma.
SIDE EFFECTS
Drowsiness, akathisia, hyper- and hypokinesia, dry mouth, dyskinesia, tremor, dystonia, hypertonia, headache, paresthesia, attention disorder, amnesia, gait disturbance, gait disturbance, gait disturbance, gait disturbance, accommodation disorder.gait disturbance, ocular accommodation disorder, abnormal vision, vertigo, tachycardia, palpitations, nasal congestion, dyspnea, salivary hypersecretion, constipation, constipation.salivary secretion, constipation, vomiting, dyspepsia, diarrhea, urination disorders, urinary retention, polyuria, polyuria, hyperuria, hyperuria, urinary retention.urinary retention, polyuria, hyperhidrosis, pruritus, myalgia, increased appetite and weight, asthenia, fatigue, malaise, pain, insomnia, depression, anxiety, nervousness, abnormal dreams, agitation and decreased libido.
PHARMACOLOGICAL INTERACTIONS
Zuclopenthixol potentiates the sedative effect of alcohol, barbiturates and other CNS (central nervous system) depressants.
Risk of neurotoxicity and QT interval increase with lithium which is recommended to be avoided.
Mutual inhibition of metabolism with tricyclic antidepressants.
Decreases the effect of levodopa and adrenergic drugs.
Risk of extrapyramidal reaction with metoclopramide and piperazine.
Increased risk of increasing QT interval with class Ia and III antiarrhythmics (quinidine, amiodarone, sotalol, dofetilide), thioridazine, erythromycin, terfenadine, astemizole, moxifloxacin, gatifloxacin and cisapride, which should be avoided.
Increased risk of electrolyte alteration with thiazide diuretics.
BRAND NAME
- Clopixol ®
Bibliography
Beunk L, Nijenhuis M, Soree B, et al. Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6, CYP3A4 and CYP1A2 and antipsychotics. Eur J Hum Genet. 2024 Mar;32(3):278-285.
Swen JJ, Nijenhuis M, de Boer A, et al . Pharmacogenetics: from bench to byte--an update of guidelines. Clin Pharmacol Ther. 2011 May;89(5):662-73.