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| Interactions: | AmitriptylineIncreased risk of postural hypotension
Amoxapine Increased risk of postural hypotension
Cisapride Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of cisapride and phenothiazines is contraindicated.
ClomipramineIncreased risk of postural hypotension
Clonidine Adverse Effect: An increased risk of dementia
Clinical Management: Monitor patients receiving both fluphenazine and clonidine for signs of acute organic brain syndrome (aggressiveness, agitation, anxiety, hallucinations).
Dothiepin Increased risk of postural hypotension
Doxepin Adverse Effect: Increased risk of postural hypotension
Erithrityl TetranitrateIncreased risk of postural hypotension
Fluoxetine Adverse Effect: An increased risk of developing acute parkinsonism
Clinical Management: Monitor patients receiving concurrent therapy with fluphenazine and fluoxetine for the development of drug-induced parkinsonism. Therapy with fluoxetine may need to be discontinued.
Glyceryl Trinitrate Increased risk of postural hypotension
Imipramine Increased risk of postural hypotension
Isosorbide 5 Mononitrate Increased risk of postural hypotension
Isosorbide Dinitrate Increased risk of postural hypotension
Levodopa Adverse Effect: Decreased levodopa effectiveness
Clinical Management: Monitor therapeutic efficacy of levodopa; larger doses may be needed with concomitant Fluphenazine therapy.
Lithium Adverse Effect: weakness, dyskinesias, increased extrapyramidal symptoms, encephalopathy, and brain damage Clinical Management: Monitor patients closely for any signs of toxicity or extrapyramidal symptoms, especially if high doses of antipsychotic drugs and lithium are used
Nitroxazapine Increased risk of postural hypotension
NortriptylineIncreased risk of postural hypotension
Pentaerythritol Tetranitrate Increased risk of postural hypotension
Pethidine Adverse Effect: an increase in central nervous system and respiratory depression
Clinical Management: Monitor patients for signs of respiratory depression, CNS depression, and hypotension. A dosage reduction or discontinuation of one or both drugs may be necessary.
Phenytoin Adverse Effect: Increased or decreased phenytoin levels and possibly reduced Fluphenazine levels Clinical Management: Consider monitoring phenytoin levels when a Fluphenazine is added or discontinued from therapy; dosage adjustments may be needed in some cases. The patient should also be observed for any signs of phenytoin toxicity (ataxia, nystagmus, tremor, hyperreflexia), particularly in the case of adjustments to the Fluphenazine dosage. Observe patients for Fluphenazine efficacy.
PimozideAdverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: Pimozide is contraindicated in individuals with congenital QT syndrome, patients with a history of cardiac arrhythmias, or patients taking other drugs which may prolong the QT interval.
ProcyclidineAdverse Effect: decreased phenothiazine serum concentrations, decreased phenothiazine effectiveness, enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth)
Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with phenothiazine derivatives as prophylaxis against possible extrapyramidal symptoms; use should be reserved for situations where EPS occur and lowering of the antipsychotic dosage is not possible.
Sertraline Adverse Effect: An increased risk of developing acute parkinsonism
Clinical Management: Monitor patients receiving concurrent therapy with fluphenazine and sertraline for the development of drug-induced parkinsonism. Therapy with sertraline may need to be discontinued.
SotalolAdverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Clinical Management: The concurrent administration of sotalol and a phenothiazine is not recommended.
Sparfloxacin Adverse Effect: prolongation of the QTc interval and/or torsades de pointes
Clinical Management: Sparfloxacin is contraindicated in individuals with known QTc prolongation or in patients being treated concurrently with drugs that are known to increase the QTc interval and/or cause torsades de pointes.
Tramadol Adverse Effect: an increased risk of seizures
Clinical Management: Caution should be used if tramadol is to be administered to patients receiving phenothiazine therapy. If possible, avoid this combination.
Trazadone Adverse Effect: Hypotension
Clinical Management: Monitor blood pressure, particularly in patients who might be sensitive to this effect. Advise patient to rise slowly from lying or sitting position.
TrihexiphenidylAdverse Effect: decreased phenothiazine serum concentrations, decreased phenothiazine effectiveness, and enhanced anticholinergic effects (ileus, hyperpyrexia, sedation, dry mouth)
Clinical Management: Anticholinergics (benztropine, orphenadrine, procyclidine, trihexyphenidyl) should not be used routinely with phenothiazine derivatives as prophylaxis against possible extrapyramidal symptoms.
TrimipramineIncreased risk of postural hypotension |
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