Flupenthixol, commonly known as Depixol and Fluanxol, is a typical, first-generation antipsychotic medication of the thioxanthene class, that is primarily used to treat schizophrenia. Always consult with your doctor if you are taking any other medications, have allergies, or have been diagnosed with other medical conditions, as misuse of Flupenthixol can have dangerous consequences.
Key takeaways
- Flupenthixol is a first-generation antipsychotic used primarily for schizophrenia and available in oral or injectable forms.
- Its dopamine-related effects can produce movement problems and other adverse reactions requiring monitoring.
- Medical history and potential drug interactions influence safe treatment, and serious reactions require urgent care.
Flupenthixol brand names
Flupenthixol is commonly sold under the following brand names:
- Fluanxol
- Depixol
- Jexit
What is flupenthixol prescribed for?
Flupenthixol is primarily prescribed for the treatment of schizophrenia, in cases where the main symptoms do not include agitation, excitement, or hyperactivity. Since schizophrenic patients often have difficulty with treatment compliance, it is often given in the form of a long-acting injection[4].
The depot formulation is used for long-term treatment of schizophrenia[1].
Indications depend on the formulation. The depot leaflet describes schizophrenia treatment, rather than a low-dose depression regimen[1].
How does flupenthixol work?
Flupenthixol blocks dopamine receptors. The depot leaflet describes its role in controlling symptoms over time[3][1].
How is flupenthixol usually taken?
Flupenthixol is taken either orally as a tablet or through an intramuscular injection. It may take several weeks to see the full effects of this medication. Do not stop taking it without speaking to your doctor.
Tablet and depot doses are not interchangeable. A clinician sets the formulation and dose for the individual[1].
A doctor or nurse must administer the slow-acting injection form of the drug. They will inject the drug into the muscles of your buttocks or upper leg during a scheduled appointment once every two or three weeks[2]. Available doses are 2% or 10%.
Severe side effects may be difficult to predict, so patients should be under close medical supervision until they have reached a stable dose.
Subject matter expert
Clinical pharmacy and medication
View profileHow long does flupenthixol stay in your system?
Depot medicine releases slowly after injection. Follow the prescribed schedule and discuss progress with your clinician[1][3].
The half-life of flupenthixol is 35 hours in tablet form or three to eight days for the injection[4]. Half-life is the time it takes for the medication in your system to decrease by half.
After an injection, flupenthixol is still detectable in the blood for up to three weeks[2].
Flupenthixol side effects
Flupenthixol can cause adverse reactions in some people. Listed below are some of the most common side effects. This list is not conclusive, so let your doctor know if you experience any other unexpected adverse effects.
Mild Side Effects
These side effects are somewhat common[3] and can affect roughly one in ten people taking the drug:
- Fatigue
- Dry mouth
- Dizziness
- Changes in weight
- Constipation
- Increased sweating
- Increased skin sensitivity to sunlight
- Insomnia
- Producing more saliva than usual
- Pain at the injection site
- Muscle spasms and aches
- Muscle stiffness
Severe Side Effects
The following side effects[3] may affect up to one in ten people:
- Blurred vision or other eye problems
- Decreased blood pressure, including fainting or dizziness
- Fast or throbbing heartbeat
- Shortness of breath
These side effects are uncommon[3], but they may affect one in 100 people:
- Skin rash
- Signs of a serious allergic reaction
- An erection lasting 4 or more hours
- Confusion
Rarely[3], the following side effects can occur:
- Seizures
- Unusual muscle movements (such as tremors, stiffness, or restlessness)
- Signs of liver damage (such as yellowing of the skin or eyes, dark urine, abdominal pain, and loss of appetite)
Signs of neuroleptic malignant syndrome
Neuroleptic Malignant Syndrome is a rare but potentially fatal condition. Symptoms include:
- High fever
- Irregular or racing heartbeat
- Confusion
- Fainting or loss of consciousness
- Muscle rigidity
- Sweating[2]
If you experience any of these symptoms, you should stop taking the drug immediately and seek medical attention.
Tardive dyskinesia
Tardive dyskinesia is a rare condition that can develop with continued use. It can cause involuntary, repetitive movements, especially in the face, neck, legs, and arms. Contact your doctor if you notice any of these symptoms:
- Lip smacking and uncontrollable tongue movements
- Grimacing
- Difficulty swallowing
- Neck twisting
- Uncontrolled movements[1]
Elevated prolactin levels
Although rare, flupenthixol can increase prolactin levels. Too much of this hormone can decrease the production of estrogen and testosterone, leading to the following symptoms:
- Changes in the menstrual cycle
- Sexual dysfunction
- Enlarged breasts in men
- Unusual breast milk (in men and women)
- Fertility problems[2]
If you experience mild side effects that are bothersome, contact your doctor to discuss your options. If you notice any severe side effects, seek immediate medical care from your doctor or the nearest emergency room.
Flupenthixol precautions
Before taking flupenthixol, let your doctor know of any other medications you are taking, as well as any known allergies. Tell your doctor if you are pregnant or breastfeeding, as there have been reports of side effects and withdrawal symptoms in infants exposed to the drug[2].
Inform your doctor if you regularly consume alcohol or if you take opiates or barbiturates, or if you have had any brain damage or circulatory failure. Taking flupenthixol in these cases can be dangerous, as it increases the sedative effects[2].
Flupenthixol is not recommended for patients with dementia, as an increased risk of stroke has been reported in this population[2]. There may also be an increased risk of death in patients with dementia-related psychosis[2].
Tell your prescriber about heart or blood-vessel problems[1].
It is generally not recommended to take this drug if you have Parkinson’s disease. Flupenthixol can make symptoms worse[2].
Tell your prescriber if you have diabetes so treatment and monitoring can be reviewed[1][2].
It’s important to discuss any history of seizures with your doctor, as flupenthixol can decrease your threshold for seizures[2].
Glaucoma should also be discussed before treatment[1].
Liver damage can cause this drug to build up in the body, which increases the risk of side effects. Flupenthixol can also make liver disease worse[3].
Additionally, tell your doctor if you have any of the following medical conditions:
- Cerebrovascular insufficiency
- Renal insufficiency
- Hypersensitivity to thioxanthenes or phenothiazine derivatives
- Kidney disease
- Family history of blood clots
- Risk factors for stroke
- Prostate problems
Do not drive or operate heavy machinery until you know how this medication affects you, as it can cause drowsiness. Use sunscreen and limit your time in the sun, as this medication can also increase sun sensitivity[2].
Flupenthixol interactions
The following medications are known to have potentially dangerous interactions with flupenthixol. Please note that this list is not exhaustive and only lists the most severe interactions. Always inform your doctor of all other medications you are taking.
Review other antipsychotics and metoclopramide with your pharmacist because interactions can occur[1].
Levodopa is another medicine requiring an interaction review[1].
This medication can increase the risk of heart problems when taken with antiarrhythmics, like quinidine, or certain antibiotics, including erythromycin[2]. Flupenthixol should not be taken with lithium, as this combination can increase the risk of arrhythmias and other heart problems[2].
Blood-pressure medicines, including guanethidine, may interact[1].
Flupenthixol can increase sedative effects when taken with other drugs that cause drowsiness, such as opioids, barbiturates, muscle relaxants, tricyclic antidepressants, and antihistamines[2].
Flupenthixol storage
To maintain its efficacy, make sure to store flupenthixol properly. Tablets should be stored in a tightly closed container at room temperature. Do not store them in the bathroom[2]. If you’re taking the injection form, your doctor will store the medication at room temperature, away from direct light and heat.
What to do if you overdose on flupenthixol
Although rare, the effects of an overdose can include:
- Agitation, confusion, excitement, and convulsions, followed by sedation
- Unconsciousness
- Extremely low or high body temperature
- Low blood pressure
- Weak pulse
- Fast heart rate[2]
Suspected overdose needs urgent medical advice, poison-center assistance, or emergency care. Do not wait for symptoms to worsen[1].
