Flupentixol: Uses, Interactions and Safety

Uses

Flupentixol is a thioxanthene antipsychotic. This summary focuses on oral tablets. Turkish Fluanxol 3 mg labeling concerns schizophrenia and other psychoses, while the UK 0.5 mg and 1 mg products have a depression indication. Strength and country therefore matter when interpreting what treatment is approved.

Administration

Follow the exact prescription and review response and tolerability regularly. A decanoate depot injection has different administration and conversion instructions and should not be substituted directly for oral tablets. There is insufficient clinical experience to recommend routine pediatric use.

Safety

Movement effects can include akathisia, tremor and stiffness. Flupentixol may also cause sleep disturbance, postural hypotension and QT prolongation. Discuss cardiac disease, electrolyte abnormalities, epilepsy, glaucoma, urinary problems and liver disease before treatment. Contraindications include severe depression requiring ECT or hospital admission, excitement or mania, circulatory collapse, coma, or depressed consciousness from intoxication. Antipsychotic use in older people with dementia-related psychosis is associated with increased mortality.

Interactions

The label advises avoiding concurrent antipsychotics unless a specialist plans an exception or a supervised transition. Avoid alcohol. Other sedatives increase central nervous system depression, while antimuscarinic medicines can increase urinary retention or constipation. Metoclopramide can increase movement adverse effects. Lithium should generally be avoided because of neurotoxicity and QT concerns. Medicines that significantly prolong QT, including sotalol, amiodarone and moxifloxacin, should generally be avoided. Potassium-depleting diuretics require caution and electrolyte monitoring. Some blood pressure medicines can cause additional hypotension, whereas clonidine’s effect may be opposed. Levodopa benefit may be reduced.

Pregnancy and breastfeeding

Use in pregnancy only after weighing the mother’s treatment needs against possible fetal risks. Late exposure may produce newborn movement or withdrawal symptoms. Flupentixol enters milk in small amounts; any breastfeeding plan needs clinician review and infant observation.

Adverse effects

Report persistent restlessness or new involuntary movements. Seek urgent care for fever with stiff muscles and confusion, fainting, marked palpitations or severe allergy. Do not stop treatment abruptly without a plan.

Sources

• Fluanxol 0.5 mg and 1 mg film-coated tablets – SmPC (01/2021)
• Turkish product information: FLUANXOL 3 mg film-coated tablets (09.06.2017 (§10); filename approved 09.03.2020)