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Dosage Adult: PO Schizophrenia Initial: 2 mg/day, up to 4 mg/day on the 2nd

day if needed. May further adjust doses at wkly intervals. Maintenance:


4-6 mg/day. Max: 16 mg/day. Acute manic episodes of bipolar
disorder Initial: 2-3 mg once daily. May increase slowly if needed. Max:
6 mg/day. IM Schizophrenia Give oral risperidone for a few days to
assess tolerability before IM inj. For patients not stabilised on oral
risperidone or patients stabilised on oral risperidone for 2 wk in doses
4 mg/day: 25 mg 2 wkly. For patients stabilised on oral risperidone for
2 wk in doses >4 mg/day: 37.5 mg 2 wkly. Continue oral risperidone for
the 1st 3 wk after the 1st inj.
Click to view risperidone Dosage by Indications
Administration May be taken with or without food.
Overdosage For action to be taken in the event of accidental overdose ... click to view
risperidone
Special Preexisting CV diseases; discontinue use if signs and symptoms of
Precautions tardive dyskinesia occur; renal and hepatic impairment, elderly, epilepsy;
parkinsonism; pregnancy. May cause drowsiness and orthostatic
hypotension. Gradual withdrawal is recommended. Monitor blood
glucose in diabetics and patients at risk of developing diabetes.
Adverse Drug Agitation, anxiety, dizziness, headache, somnolence; orthostatic
Reactions hypotension; constipation, dyspepsia, nausea, vomiting, abdominal pain,
blurred vision, erectile dysfunction, priapism, rhinitis, rash and allergy,
galactorrhoea, gynaecomastia, menstrual disorders, extrapyramidal
symptoms (rarely). weight gain, oedema, tardive dyskinesia.
Potentially Fatal: Neuroleptic malignant syndrome may occur rarely;
seizures. May cause increased mortality in elderly with dementia-related
psychosis.
Drug Interactions May antagonise the effects of levodopa and dopamine agonists. May
increase serum levels of clozapine when used together. Increased serum
levels of carbamazepine when used concurrently. Carbamazepine may
also decrease the serum levels of risperidone. Increased risk of
neuroleptic malignant syndrome when used with indinavir and ritonavir.
Potentially Fatal: Risperidone may enhance the hypotensive effect of
certain antihypertensives.
Click to view more risperidone Drug Interactions
Dosage Adult: PO Prevention of drug-induced extrapyramidal
symptoms Initial: 1 mg/day, increased gradually. Maintenance: 5-15
mg/day in 3-4 divided doses. Max: 15
mg/day. Idiopathic parkinsonism Initial: 1 mg/day in 3-4 divided doses,
increased gradually up to 6-10 mg/day according to response. Advanced
cases: 12-15 mg/day in 3-4 divided doses. Postencephalitic patients:
Larger doses may be needed.
Click to view trihexyphenidyl hydrochloride Dosage by Indications
Administration Should be taken with food. (Best taken w/ meals. Take before meals if
dry mouth occurs, after meals if drooling/nausea occurs. Take at the same
time each day.)
Overdosage For action to be taken in the event of accidental overdose ... click to view
trihexyphenidyl hydrochloride
Contraindications Patients with closed-angle glaucoma, chronic pulmonary disease, sick
sinus syndrome, thyrotoxicosis, cardiac failure with tachycardia.
Special Glaucoma, obstructive disease of GI or genitourinary tracts. In elderly
Precautions males with possible prostatic hypertrophy. Liver and renal disorders.
Pregnancy and lactation.
Adverse Drug Dry mouth, blurring of vision, constipation, urinary retention, glaucoma,
Reactions confusion, drowsiness, restlessness, hallucinations.
Potentially Fatal: Arrhythmias, AV dissociation, multiple ventricular
ectopics.
Drug Interactions Delayed absorption of other oral drugs.
Potentially Fatal: Additive anticholinergic activity with tricyclic
antidepressants, antiparkinsonian drugs, antihistaminics, phenothiazine
and quinidine.
Click to view more trihexyphenidyl hydrochloride Drug Interactions
Mechanism of For details of the mechanism of action, pharmacology and
Action pharmacokinetics and toxicology ... click to view trihexyphenidyl
hydrochloride
MIMS Class Antiparkinsonian Drugs
Dosage Adult: PO Intractable hiccup Initial: 25-50 mg 3-4 times/day for 2-3
days. Psychoses 25 mg 3 times/day. Maintenance: 25-100 mg 3
times/day, increased to 1 g/day if needed in psychotic
patients. IM Psychoses 25-50 mg 6-8 hrly. Nausea and vomiting Initial:
25 mg via IM inj, followed by 25-50 mg 3-4 hrly
until vomiting stops. Rectal Psychoses As supp: 100 mg 6-8 hrly .
Click to view chlorpromazine Dosage by Indications
Administration May be taken with or without food. (May be taken w/ meals to reduce GI
discomfort.)
Overdosage For action to be taken in the event of accidental overdose ... click to view
chlorpromazine
Contraindications Hypersensitivity; preexisting CNS depression, coma, bone-marrow
supression; phaeochromocytoma; lactation.
Special Parkinson's disease; CV disease; renal or hepatic impairment;
Precautions cerebrovascular and respiratoty disease; jaundice; DM; hypothyroidism;
paralytic ileus; prostatic hyperplasia or urinary retention; epilepsy or
history of seizures; myasthenia gravis; pregnancy; elderly (especially
with dementia), and debilitated patients. Avoid direct sunlight.
Adverse Drug Tardive dyskinesia (on long-term therapy). Involuntary movements of
Reactions extremities may also occur. Dry mouth, constipation, urinary retention,
mydriasis, agitation, insomnia, depression and convulsions; postural
hypotension, ECG changes. Allergic skin reaction, amenorrhoea,
gynaecomastia, weight gain. Hyperglycaemia and raised serum
cholesterol.
Potentially Fatal: Agranulocytosis. Instantaneous deaths associated with
ventricular tachyarrhythmias. Marked elevation of body temperature with
heat stroke. Neuroleptic malignant syndrome, extrapyramidal
dysfunction.
Drug Interactions Potentiation of anticholinergic effects of antiparkinson agents and TCAs
may lead to an anticholinergic crisis. Additive orthostatic hypotensive
effect in combination with MAOIs. Reverses antihypertensive effect
of guanethidine, methyldopa andclonidine.
Potentially Fatal: Additive depressant effect with sedatives, hypnotics,
antihistamines, general anaesthetics, opiates andalcohol.
Click to view more chlorpromazine Drug Interactions
Pregnancy
Category (US
FDA) Category C: Either studies in animals have revealed adverse effects on
the foetus (teratogenic or embryocidal or other) and there are no
controlled studies in women or studies in women and animals are not
available. Drugs should be given only if the potential benefit justifies the
potential risk to the foetus.
Mechanism of For details of the mechanism of action, pharmacology and
Action pharmacokinetics and toxicology ... click to view chlorpromazine
MIMS Class Antiemetics / Antipsychotics
ATC N05AA01 - chlorpromazine ; Belongs to the class of phenothiazine
Classification antipsychotics with aliphatic side-chain.
Dosage Adult: PO Psychoses 0.5-5 mg 2-3 times/day, up to 100 mg/day in severe cases.
Maintenance: 3-10 mg/day. Severe tics; Tourette's syndrome Initial: 0.5-1.5 mg
3 times/day, up to 10 mg/day in Tourette's syndrome. Adjunct in
severe anxiety or behavioral disturbances 0.5 mg twice daily. Restlessness
and confusion 1-3 mg 8 hrly. Intractable hiccup 1.5 mg 3 times/day. IM Acute
psychosis 2-10 mg hrly or 4-8 hrly until symptoms are controlled. Max: 18
mg/day. Nausea and vomiting0.5-2 mg/day. SC Restlessness and confusion 5-
15 mg over 24 hr.
Click to view haloperidol Dosage by Indications
Administration May be taken with or without food. (May be taken w/ meals to minimise GI
irritation.)
Overdosage For action to be taken in the event of accidental overdose ... click to view
haloperidol
Contraindications Severe toxic CNS depression; preexisting coma; Parkinson's disease; lactation.
Special Parkinsonism; epilepsy, allergy, angle-closure glaucoma, benign prostatic
Precautions hyperplasia; severe cardiac or hepatic disease; extremes in temp (hot and cold
weather); presence of acute infections or leucopenia; hyperthyroidism;
pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue
upon signs of neurological toxicity in patients taking haloperidol and lithium.
Adverse Drug Tardive dyskinesia; extrapyramidal reactions. Anxiety, drowsiness, depression,
Reactions anorexia, transient tachycardia, postural hypotension, leukopenia;
anticholinergic side effects.
Potentially Fatal: Neuroleptic malignant syndrome.
Drug Interactions Carbamazepine and rifampicin reduce plasma concentrations. Symptoms of
CNS depression may be enhanced by CNS depressants e.g. alcohol, hypnotics,
general anaesthetics, anxiolytics and opioids. May reduce antihypertensive
action ofguanethidine. May increase risk of arrhythmia when used with drugs
that prolong QT interval or diuretics that can cause electrolyte imbalance. May
increase plasma levels of haloperidol when used
with clozapine or chlorpromazine.
Potentially Fatal: Increases lithium blood levels and may predispose to
neuroleptic malignant syndrome.
Click to view more haloperidol Drug Interactions
Pregnancy
Category (US
FDA) Category C: Either studies in animals have revealed adverse effects on the
foetus (teratogenic or embryocidal or other) and there are no controlled studies
in women or studies in women and animals are not available. Drugs should be
given only if the potential benefit justifies the potential risk to the foetus.
Mechanism of For details of the mechanism of action, pharmacology and pharmacokinetics
Action and toxicology ... click to view haloperidol
MIMS Class Antipsychotics / Antivertigo Drugs
ATC Classification N05AD01 - haloperidol ; Belongs to the class of butyrophenone derivatives
antipsychotics.