Adults

For psychosis: Initially 3-6 mg daily, increased if necessary up to a maximum of 12 mg daily. Doses above 12 mg are typically divided. For depression (low dose): 0.5-1 mg daily, adjusted up to 3 mg daily. Breton 2 mg is often used for maintenance or starting doses in some conditions.

Elderly

Lower initial doses and slower titration are recommended. Max 6 mg daily for psychosis, 1 mg daily for depression.

Renal_impairment

Use with caution. No specific dose adjustment guidelines, but lower doses may be considered due to potential for accumulation of metabolites. Monitor carefully.

Onset

Antipsychotic effects may become apparent within a few days to weeks, while antidepressant effects may take 2-3 weeks. Acute sedation may occur within hours.

Excretion

Mainly excreted in feces via bile, with a smaller portion excreted in urine.

Half life

Approximately 35 hours (for oral dose).

Absorption

Well absorbed from the gastrointestinal tract following oral administration, but undergoes significant first-pass metabolism, leading to variable bioavailability (around 40%). Peak plasma concentrations are reached in 3-8 hours.

Metabolism

Extensively metabolized in the liver, primarily by sulfoxidation, N-dealkylation, and glucuronic acid conjugation. CYP2D6 is involved in its metabolism.

Hypotensive Agents

Enhanced hypotensive effect, leading to orthostatic hypotension.

Anticholinergic Agents

Increased anticholinergic effects such as dry mouth, constipation, blurred vision.

Dopamine Agonists (e.g., levodopa)

Antagonistic effects, reducing the efficacy of dopamine agonists.

CNS Depressants (alcohol, barbiturates, opioids)

May potentiate CNS depressant effects, leading to increased sedation.

CYP2D6 Inhibitors (e.g., paroxetine, fluoxetine, quinidine)

May increase plasma concentrations of flupentixol.

QT-prolonging Drugs (e.g., antiarrhythmics, some antibiotics)

Increased risk of QT interval prolongation and cardiac arrhythmias.