Breton
Generic Name
Flupentixol 2 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| breton 2 mg tablet | ৳ 2.50 | ৳ 25.00 |
Description
Overview of the medicine
Breton 2 mg Tablet contains Flupentixol, which is a typical antipsychotic medication. It is primarily used to treat schizophrenia, other psychoses, and sometimes as an adjunct in severe depression with anxiety or apathy, particularly at lower doses.
Uses & Indications
Dosage
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.
How to Take
Breton tablets should be taken orally, usually once or twice daily, with or without food. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Flupentixol primarily acts as a dopamine receptor antagonist, blocking D1 and D2 dopamine receptors in the brain. This action helps to reduce positive symptoms of psychosis such as hallucinations and delusions. At lower doses, it also exhibits some anxiolytic and antidepressant properties, possibly due to its effects on presynaptic dopamine receptors or other neurotransmitter systems.
Pharmacokinetics
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.
Side Effects
Contraindications
- Hypersensitivity to Flupentixol or any other thioxanthene derivatives
- Acute alcohol, barbiturate, or opiate intoxication
- Coma or severe CNS depression
- Circulatory collapse
- Severe cardiovascular disorders
- Severe liver disease
Drug Interactions
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.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, coma, extrapyramidal symptoms (e.g., dystonia, parkinsonism), hypotension, hypothermia, and convulsions. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered if recent ingestion. Monitor cardiovascular and respiratory functions.
Pregnancy & Lactation
Breton should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotic drugs during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms. Flupentixol is excreted in breast milk; therefore, breastfeeding is not recommended.
Side Effects
Contraindications
- Hypersensitivity to Flupentixol or any other thioxanthene derivatives
- Acute alcohol, barbiturate, or opiate intoxication
- Coma or severe CNS depression
- Circulatory collapse
- Severe cardiovascular disorders
- Severe liver disease
Drug Interactions
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.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, coma, extrapyramidal symptoms (e.g., dystonia, parkinsonism), hypotension, hypothermia, and convulsions. Treatment is symptomatic and supportive. Gastric lavage and activated charcoal may be considered if recent ingestion. Monitor cardiovascular and respiratory functions.
Pregnancy & Lactation
Breton should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonates exposed to antipsychotic drugs during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms. Flupentixol is excreted in breast milk; therefore, breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture
Availability
Pharmacies
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Flupentixol has been subject to extensive clinical trials demonstrating its efficacy in reducing symptoms of schizophrenia and other psychotic disorders. Studies also support its use in low doses for certain types of depression.
Lab Monitoring
- Complete blood count (CBC) periodically, especially if fever or sore throat develops.
- Liver function tests (LFTs) periodically.
- Electrocardiogram (ECG) before treatment and periodically during treatment, especially in patients with cardiac risk factors or concomitant use of other QT-prolonging drugs.
- Blood glucose and lipid profile due to risk of metabolic changes.
Doctor Notes
- Counsel patients on potential extrapyramidal symptoms and monitor for their occurrence, especially during initiation and dose adjustments.
- Emphasize the importance of adherence to prevent relapse. Do not allow abrupt discontinuation.
- Consider lower starting doses and slower titration for elderly patients and those with hepatic impairment.
- Screen for metabolic risk factors (glucose, lipids, weight) at baseline and periodically during treatment.
Patient Guidelines
- Take Breton exactly as prescribed by your doctor. Do not stop taking it suddenly, even if you feel better, as this can lead to withdrawal symptoms.
- Avoid alcohol while taking this medication, as it can increase drowsiness.
- Report any unusual side effects, especially uncontrollable movements, fever, or muscle stiffness, to your doctor immediately.
- Be careful when standing up from a sitting or lying position, as this medicine can cause dizziness and a drop in blood pressure.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Breton may cause drowsiness, dizziness, or blurred vision, which can impair your ability to drive or operate machinery. Avoid such activities until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including regular exercise and a balanced diet, to help manage potential weight gain and metabolic side effects.
- Stay hydrated. Avoid extreme heat, as antipsychotics can affect body temperature regulation.
- Regular follow-up appointments with your doctor are crucial for monitoring your condition and adjusting treatment if necessary.
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