Fluphenazine Hydrochloride + Nortriptyline

Introduction: Fluphenazine Hydrochloride + Nortriptyline is a combination medicine used in the treatment of schizophrenia, a mental disorder that can result in hallucinations or delusions. It alters thoughts and elevates mood, improving the person's ability to think, feel and behave.

How it works: Fluphenazine is a typical antipsychotic that blocks the action of dopamine in the brain. Nortriptyline is a tricyclic antidepressant that increases the levels of chemical messengers in the brain that help in regulating mood.

Important Information: This medicine may be taken with or without food, preferably at the same time each day. Take it in the dose and duration as advised by your doctor. Do not stop suddenly without talking to your doctor.

• Schizophrenia
• Mild to moderate mixed anxiety/depression
• Emotional disturbance
• Sleep disorder
• Gastric problems

Combined anxiolytics & anti-depressant drugs

Typical antipsychotic + Tricyclic antidepressant

Fluphenazine blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It reduces aggressiveness with disappearance of hallucinations and delusions. Nortriptyline is a dibenzocycloheptadiene tricyclic antidepressant that increases synaptic concentration of serotonin and norepinephrine in the CNS by blocking the neuronal reuptake of norepinephrine and serotonin.

Fluphenazine blocks dopamine receptors to reduce psychotic symptoms. Nortriptyline blocks neurotransmitter reuptake to improve mood.

Adult Dose:

• 1 tablet 2 to 3 times daily.

Child Dose:

• Not recommended in children.

* Use as directed by the registered physician

Oral tablet. Can be taken with or without food. Swallow whole, do not chew or crush.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow your regular schedule. Do not double the dose.

Common Side Effects:

• Dryness in mouth
• Constipation
• Weight gain
• Sleepiness
• Orthostatic hypotension
• Urinary retention
• Increased prolactin level
• Blurred vision
• Increased heart rate
• Muscle stiffness
• Restlessness
• Tremor

Rare Side Effects: Tardive dyskinesia, blood dyscrasia, malignant neuroleptic syndrome, agranulocytosis.

Precautions:

• Caution in glaucoma, prostate enlargement, cardiac failure and myocardial infarction.
• Caution with concurrent administration of CNS depressants.
• May impair alertness and ability to drive.
• Avoid during pregnancy and lactation.
• Do not stop suddenly (may worsen symptoms).

Contraindications:

• Subcortical brain damage
• Patients receiving large doses of hypnotics
• Comatose or severely depressed states
• Blood dyscrasia
• Liver damage
• Hypersensitivity to fluphenazine
• Patients taking MAO inhibitors
• Younger children

Drug Interactions:

• Reduces antihypertensive effects of guanethidine, methyldopa and clonidine.
• Increases lithium toxicity.
• Reduced bioavailability with antacids.
• Increased risk of arrhythmia with drugs that prolong QT interval.
• May cause electrolyte disturbance with diuretics.
• Additive CNS depressant effects with alcohol, barbiturates, hypnotics, sedatives, opiates and antihistamines.

Food Interactions:

• Avoid alcohol as it may cause excessive drowsiness.

Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and risks.

Use in Lactation: Probably unsafe during breastfeeding. Limited data suggests the drug may pass into breastmilk and harm the baby.

Pediatric Use: Not recommended in children.

Geriatric Use: Dose adjustment may be necessary for elderly patients. Use as per doctor's advice.

Renal Impairment: Limited information available. Please consult your doctor.

Hepatic Impairment: Use with caution in liver disease. Not recommended in severe liver disease. Inform your doctor if you develop signs of jaundice.

Overdose: Overdose may cause somnolence, confusion and coma. Gastric lavage and supportive measures should be employed.

Storage: Store below 30°C, away from light and moisture. Keep out of reach of children.

Fluphenazine Hydrochloride + Nortriptyline Tablet