Flupagen IM/SC Injection

Flupagen is indicated in the long-term management of psychotic disorders including:

• Schizophrenia
• Mania and
• Organic brain syndrome.

Fluphenazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It produces calmness and reduces aggressiveness with disappearance of hallucinations and delusions. Fluphenazine Decanoate is a phenothiazine derivative. It is a highly potent antipsychotic agent with a markedly extended duration of action, available for intramuscular administration. The esterification of Fluphenazine with decanoic acid markedly prolongs the drugs duration of effect without reducing its activity

Fluphenazine Decanoate by deep intramuscular injection into the gluteal muscle, test dose 12.5 mg (6.25 mg in elderly), then after 4-7 days 12.5-100 mg repeated at intervals of 14-35 days, adjusted according to response; it is not recommended for children.

Flupagen reverses antihypertensive effects of Guanethidine, Methyldopa and Clonidine. It also causes lithium toxicity by interacting with it. Antacids may reduce bioavailability of phenothiazines. Additive CNS depressant effects produced with alcohol, barbiturates, hypnotics, sedatives, opiates and antihistamines.

Fluphenazine Decanoate oily Injection is contraindicated in patients with hypersensitivity to the drug. Also contraindicated in comatose or severely depressed states, blood dyscrasias, liver disease, pregnancy (3rd trimester), lactation.

The side effects include tardive dyskinesia, sedation, mental confusion; hypotension; hyperprolactinaemia leading to galactorrhoea and amenorrhoea in women; loss of libido, impotence and sterility in males. Also include allergic reactions, cholestatic jaundice, corneal and lens deposists, skin pigmentation. Other potential adverse reactions are agranulocytosis; neuroleptic syndrome.

The safety for the use of Fluphenazine decanoate during pregnancy has not yet been established; therefore the possible hazards should be weighed against the potential benefits when administering this drug to pregnant patients.

Special precaution should be practiced in presence of convulsive disorders; hepatic, renal, cerebrovascular, respiratory and cardiovascular diseases. Also precaution should be observed in case of phenochromocytoma; bone marrow suppression; elderly or debilitated patients.

Symptoms of overdose may include Muscle weakness, an irregular heart rhythm and breathing difficulty.

Phenothiazine drugs

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