Fluphenazine
Risk Factor: C
Class: CENTRAL NERVOUS SYSTEM DRUGS
/ Tranquilizers
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
Fetal Risk Summary
Fluphenazine is a piperazine phenothiazine in the same group as prochlorperazine. Phenothiazines readily cross the placenta (1).
Shepard reviewed two studies in which fluphenazine was given to pregnant rats at doses up to 100 mg/kg orally without producing adverse fetal effects (2). Pregnant mice were given fluphenazine (1 mg/kg) or diphenylhydantoin (50 mg/kg), or both, by gavage during organogenesis (3). As compared with controls, a significant reduction in fetal weight and length was observed in all treatment groups. The combination produced a significant increase in the incidence of skeletal defects (incomplete ossification of sternebrae and skull bones) and in the incidence of dilated cerebral ventricles (already increased in the fluphenazine-alone group) (3).
An apparently normal pregnancy outcome was described in a woman receiving psychotherapy and being treated with fluphenazine decanoate (2 mL IM every 3 weeks) (4). In addition, she also smoked cigarettes (up to 4 packs/day) and drank four or five cocktails each evening. She eventually delivered a 1-week postterm 3.38-kg, male infant, who developed minor extrapyramidal symptoms (or withdrawal) 4 weeks after delivery. The symptoms readily responded to oral diphenhydramine. At 2 months of age, the infant was healthy and weighed 4.66 kg. The infant boy was reported by the mother to be doing well at 20 months of age.
A 22-year-old woman with schizophrenia was treated with chlorpromazine (up to 1200 mg/day) throughout gestation, fluphenazine decanoate (50 mg IM every 2 weeks) from the 14th week of gestation, and electroconvulsive therapy at 18 weeks' (5). The fluphenazine dose was increased to 100 mg IM every 2 weeks at 24 weeks' gestation. In addition, she smoked 3 to 4 packs of cigarettes per day. An apparently normal, 3.53-kg male infant was delivered by cesarean section at 39 weeks' who did well during the first 3 weeks. At that time (6 weeks after the mother's last fluphenazine dose), the infant developed excessive irritability, choreiform and dystonic movements mostly in the upper limbs, jittery behavior, and hypertonicity. Two doses of diphenhydramine given on the 24th and 25th days failed to resolve the condition. Over the next few weeks, the symptoms subsided only to return on the 58th day with the same earlier intensity (5). Diphenhydramine (62.5 mg) was restarted every 6 hours with slow improvement in his condition. At 15 weeks of age, the infant's progress appeared normal and at 6 months of age, the diphenhydramine was gradually withdrawn. Follow-up at 15 months of age was normal. The authors attributed the infant's condition to fluphenazine withdrawal (5).
An infant with multiple anomalies was born to a mother treated with fluphenazine enanthate injections throughout pregnancy (6). The mother also took Debendox (see Doxylamine) during the 1st trimester. Anomalies included: ocular hypertelorism with telecanthus, cleft lip and palate, imperforate anus, hypospadias of penoscrotal type, jerky, roving eye movements, episodic rapid nystagmoid movements, rectourethral fistula, and poor ossification of frontal skull bone. Other reports have indicated that the phenothiazines are relatively safe during pregnancy (see also Prochlorperazine).
In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 13 newborns had been exposed to fluphenazine during the 1st trimester (F. Rosa, personal communication, FDA, 1993). One (7.7%) major birth defect was observed (0.6 expected), a cardiovascular defect (0 expected). The number of exposures is too small for comment.
A 35-year-old woman with schizophrenia was treated throughout gestation with fluphenazine, 10 mg orally twice daily, then decreased to 5 mg orally twice daily during the 3rd trimester (7). The fluphenazine concentration in cord blood was <1.0 ng/mL. She delivered a normal, 2855-g, female infant at 39 weeks' gestation who developed severe rhinorrhea and upper respiratory distress at 8 hours of age. Oral feedings were poor and complicated by periodic episodes of vomiting, course choreoathetoid movements of the arms and legs, and intermittent arching of the body (7). Marked improvement in her symptoms occurred following a single dose of pseudoephedrine solution (0.75 mg) that was repeated once the next day. Although the infant had no further extrapyramidal symptoms, the rhinorrhea and nasal congestion persisted for 3 months.
Breast Feeding Summary
No reports describing the use of fluphenazine during human lactation have been located. Because other phenothiazines cross the placenta and are excreted into milk (see also Prochlorperazine), passage of fluphenazine into milk should be expected. The American Academy of Pediatrics considers the effects of other antipsychotic phenothiazine agents (e.g., see Chlorpromazine) on the nursing infant to be unknown, but they may be of concern (8).
References
- Moya F, Thorndike V. Passage of drugs across the placenta. Am J Obstet Gynecol 1962;84:177898.
- Shepard TH. Catalog of Teratogenic Effects. 8th ed. Baltimore, MD:Johns Hopkins University Press, 1995:1901.
- Abdel-Hamid HA, Abdel-Rahman MS, Abdel-Rahman SA. Teratogenic effect of diphenylhydantoin and/or fluphenazine in mice. J Appl Toxicol 1996;16:2215.
- Cleary MF. Fluphenazine decanoate during pregnancy. Am J Psychiatry 1977;134:8156.
- O'Connor M, Johnson GH, James DI. Intrauterine effect of phenothiazines. Med J Aust 1981;1:4167.
- Donaldson GL, Bury RG. Multiple congenital abnormalities in a newborn boy associated with maternal use of fluphenazine enanthate and other drugs during pregnancy. Acta Paediatr Scand 1982;71:3358.
- Nath SP, Miller DA, Muraskas JK. Severe rhinorrhea and respiratory distress in a neonate exposed to fluphenazine hydrochloride prenatally. Ann Pharmacother 1996;30:357.
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Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
Questions and Answers
How long does the effects of a Fluphenazine injection last for?, I'm tired of waiting for it to end.
According to this site, it can last for up to two to three weeks
http://www.answers.com/topic/fluphenazin...
Does anyone have a history with a drug called Fluphenazine?,
Fluphenazine is an antipsychotic medication used to treat schizophrenia and psychotic symptoms such as hallucinations, delusions, and hostility.
fluphenazine allergic reaction?, I took fluphenazine hcl and having an allergic reaction from it .... what can fix it please help
Call the doctor straight away to see if he thinks you're having an allergic reaction or if it's actually just side effects, or if it's toxicity.
synthesis of fluphenazine?, show the synthesis pathway
Try sodium and ethylene glycol on N-hydroxyethyl ethylene diamine hydrochloride to make the piperazine, then SN2 on a tertiary amine with bromopropyl and two benzene derived substituants with the appropriate bells and whistles (-CF3, -S).
What horse products contain Capsaicin?, Ireland have been disqualified from the showjumping events in the Olympics AGAIN, along with Germany, Brazil and Norway.
Horses tested positive for Capsaicin.
I am just wondering what products used on horses contain Capsaicin?
Would it be possible to give a horse a band substance without realising?
Cian O'Connor was disqualified at the last Olympics when his horse tested positive for fluphenazine and zuclopenthixol.
What products contain these drugs?
actually "capsaicin"is used to overwhelm the nervous system in the area that it is applied causing a heat sensation and will cause a neural numbness in that area it also dilates the blood vessels in that area.there are a lot of horse products that use it and the reason it was banned was because it can take a minor injury and turn it into a permanent lameness due to the horses natural pain receptors not being able to protect the horse."equiblock"brand pain reliever has .025% capsaicin and most pain products will list it if they have any in it because of the rules of banned substances.a good trainer and coach will get the list of banned substances and then go thru all their equipment to find out if it has any banned substances in them and go as far as contacting the company's that make them so during drug testing they wont be disquallified.this falls on the trainer and grooms shoulders.
Gross...but?, Do anti-fungal medications (the prescribed pills for toe-nail fungus) interact with anti-depressants (specifically Lamictal and Fluphenazine)?
I really want to get rid of this fungus, but treating my depression is more important, of course. Can I do both?
Go to the same pharmacy where you get your anti -depressants. Have them type in Lamisil (I think that's what the doc would put you on for your nails.) With today's computers, it'll show up if the two don't mix. You can probably just call on the phone. Good luck! I'm so glad your depression is in check! I am a fellow sufferer, and doing well on Paxil. :)
Ocular Gyro Crisis?, I found out the other night that an eye problem I had for awhile was called ocular gyro crisis. Where my eyes roll to the back of my head . They took me off fluphenazine and gave contigen. I am still on Abilify which I hear can cause it too. I am trying to find more info about it but I cannot seem to find anything on it. Please can someone get more info for me. Thanks.
The exact term is "Oculogyric crisis" which may have tripped up your searches.
"oculogyric crisis - a spasmodic attack; marked by fixation of the eyeballs in one position, usually upward. "
A bare but accurate discussion is to be found at the site below.
Although distressing when occuring, it seems to have no connection with any permanent eye damage or problem.
It's not always caused by a reaction to medication, and can occue in a range of conditions.
