No

Antipsychotic Agent, Phenothiazine, Aliphatic

Treatment of psychoses; vomiting

C

Hypersensitivity to triflupromazine or any component, cross-sensitivity with other phenothiazines may exist; angle-closure glaucoma; bone marrow depression; severe liver or cardiac disease

Safety and efficacy have not been established in children <2.5 years of age; watch for hypotension when administering I.M. or I.V.; use with caution in patients with cardiovascular disease or seizures; benefits of therapy must be weighed against risks of therapy; use caution with CNS depression and severe liver or cardiac disease; avoid use in children and adolescents with suspected Reye's syndrome

Cardiovascular: Hypotension, tachycardia, syncope, peripheral edema, QT prolongation

Central nervous system: Neuroleptic malignant syndrome, extrapyramidal signs (dystonia, akathisia, pseudoparkinsonism, tardive dyskinesia), sedation, dizziness, drowsiness, insomnia, anxiety, depression, headache, seizures, NMS hyperpyrexia

Dermatologic: Photosensitivity, dermatitis, urticaria

Endocrine & metabolic: Syndrome of inappropriate antidiuretic hormone, galactorrhea, gynecomastia, hyperglycemia, hypoglycemia, breast engorgement, lactation, mastalgia

Gastrointestinal: Xerostomia, weight gain

Hematologic: Agranulocytosis, leukopenia, eosinophilia, thrombocytopenia, aplastic anemia, hemolytic anemia

Hepatic: Jaundice

Neuromuscular & skeletal: Weakness

Ocular: Nystagmus, blurred vision, keratopathy, lacrimation, pigment deposition

Phenothiazines inhibit the ability of bromocriptine to lower serum prolactin concentrations

Benztropine (and other anticholinergics) may inhibit the therapeutic response to triflupromazine and excess anticholinergic effects may occur

Chloroquine may increase triflupromazine concentrations

Cigarette smoking may enhance the hepatic metabolism of triflupromazine. Larger doses may be required compared to a nonsmoker.

Concurrent use of triflupromazine with an antihypertensive may produce additive hypotensive effects

Antihypertensive effects of guanethidine and guanadrel may be inhibited by triflupromazine

Concurrent use with TCA may produce increased toxicity or altered therapeutic response

Triflupromazine may inhibit the antiparkinsonian effect of levodopa; avoid this combination

Triflupromazine plus lithium may rarely produce neurotoxicity

Barbiturates may reduce triflupromazine concentrations

Propranolol may increase triflupromazine concentrations

Sulfadoxine-pyrimethamine may increase triflupromazine concentrations

Triflupromazine and possibly low potency antipsychotics may reverse the pressor effects of epinephrine

Triflupromazine and CNS depressants (ethanol, narcotics) may produce additive CNS depressant effects

Triflupromazine and trazodone may produce additive hypotensive effects

The sites of action appear to be the reticular activity system of the midbrain, limbic system, hypothalamus, globus pallidus, and corpus striatum. Postsynaptic, adrenergic, dopaminergic, and serotonergic receptors are blocked.

Children: I.M.: 0.2-0.25 mg/kg

Adults:

I.M.: 5-15 mg every 4 hours

I.V.: 1 mg

Should be administered with food, milk, or water

Most pharmacology textbooks state that in presence of phenothiazines, systemic doses of epinephrine paradoxically decrease the blood pressure. This is the so called "epinephrine reversal" phenomenon. This has never been observed when epinephrine is given by infiltration as part of the anesthesia procedure.

Significant hypotension may occur, especially when the drug is administered parenterally; orthostatic hypotension is due to alpha-receptor blockade, the elderly are at greater risk for orthostatic hypotension

Extrapyramidal reactions are more common in elderly with up to 50% developing these reactions after 60 years of age; drug-induced Parkinson's syndrome occurs often; Akathisia is the most common extrapyramidal reaction in elderly

Increased confusion, memory loss, psychotic behavior, and agitation frequently occur as a consequence of anticholinergic effects

Antipsychotic associated sedation in nonpsychotic patients is extremely unpleasant due to feelings of depersonalization, derealization, and dysphoria

Injection, as hydrochloride: 20 mg/mL (1 mL)