Medicine Information

Flupagen

Name: Flupagen
Brand: Flupagen
Rating: 4.5 (117 reviews)

Injection25 mgAntipsychoticsATC: N05AB02

Generic Name

Fluphenazine Decanoate 25 mg Injection

Manufacturer

DrugCo Pharma

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
flupagen 25 mg injection	৳ 75.00	N/A

Description

Overview of the medicine

Flupagen 25 mg Injection contains Fluphenazine Decanoate, a long-acting typical antipsychotic used for the maintenance treatment of schizophrenia and other psychotic disorders. It is administered intramuscularly or subcutaneously and provides symptom control for several weeks.

Uses & Indications

Maintenance treatment of schizophrenia

Management of other psychotic disorders

Patients requiring long-term parenteral antipsychotic therapy

Dosage

Adults

Initially, 12.5-25 mg intramuscularly or subcutaneously every 1-4 weeks, adjusted according to patient response and tolerance. Max dose typically 100 mg per injection.

Elderly

Lower initial doses (e.g., 6.25 mg or 12.5 mg) are recommended, with careful titration and monitoring for side effects.

Renal_impairment

No specific dose adjustments provided; use with caution and monitor for adverse effects. Consider lower doses if severe impairment.

How to Take

Administered by a healthcare professional deep into the gluteal muscle (intramuscularly) or subcutaneously. Do not administer intravenously.

Mechanism of Action

Fluphenazine decanoate is a potent antipsychotic that acts primarily by blocking postsynaptic dopamine D2 receptors in the mesolimbic and mesocortical pathways of the brain. This antagonism reduces dopamine activity, leading to its antipsychotic effects. It also has weaker alpha-adrenergic, antihistaminic, and anticholinergic properties.

Pharmacokinetics

Onset

Clinical effects usually become noticeable within 24-72 hours after injection, with full effect taking several days to a week.

Excretion

Primarily excreted in urine and feces as metabolites.

Half life

The elimination half-life of fluphenazine (from the decanoate) is approximately 7-14 days, contributing to its long duration of action.

Absorption

Slowly absorbed from the intramuscular or subcutaneous site. The decanoate ester allows for slow hydrolysis to fluphenazine, releasing the active drug gradually.

Metabolism

Metabolized in the liver via hydroxylation, N-dealkylation, and glucuronidation.

Side Effects

Contraindications

Severe central nervous system depression
Comatose states
Presence of subcortical brain damage
Blood dyscrasias
Known hypersensitivity to fluphenazine or other phenothiazines
Pheochromocytoma

Drug Interactions

Anticholinergics

Increased risk of anticholinergic side effects (e.g., dry mouth, constipation, urinary retention).

Antihypertensives

Potentiation of hypotensive effects.

Tricyclic Antidepressants

Increased plasma levels of both drugs.

CNS Depressants (e.g., alcohol, opioids, benzodiazepines)

Increased sedative effects and respiratory depression.

Storage

Store below 30°C. Protect from light and freezing. Keep out of reach of children.

Overdose

Symptoms include severe extrapyramidal reactions, hypotension, CNS depression (sedation, coma), convulsions, hyperthermia. Management is symptomatic and supportive, including maintaining airway, circulatory support, and managing extrapyramidal symptoms with antiparkinsonian drugs.

Pregnancy & Lactation

Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus (Category C). Not recommended during breastfeeding as it is excreted in breast milk and may harm the infant. Consult a doctor.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 x 1 mL ampoule5 x 1 mL ampoule

Shelf Life

2-3 years from the date of manufacture when stored under recommended conditions.

Availability

Hospitals, Pharmacies

Approval Status

Approved

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established the efficacy and safety of fluphenazine decanoate in the long-term management of schizophrenia and other psychotic disorders. Ongoing post-marketing surveillance continues to monitor its use.

Lab Monitoring

Complete blood count (CBC) periodically
Liver function tests (LFTs) periodically
Renal function tests periodically
ECG for cardiac risk (especially at higher doses or in patients with cardiac disease)

Doctor Notes

Regular monitoring for extrapyramidal symptoms, particularly tardive dyskinesia, is crucial.
Assess for NMS symptoms (fever, rigidity, altered mental status, autonomic instability) and discontinue immediately if suspected.
Consider patient adherence and social support in long-term management.
Educate patients/caregivers on potential side effects and when to seek medical attention.

Patient Guidelines

Report any unusual muscle movements (e.g., tremors, stiffness, restlessness) to your doctor immediately.
Avoid sudden changes in position to prevent dizziness from orthostatic hypotension.
Do not stop the medication abruptly without consulting your doctor.
Stay hydrated and avoid excessive heat exposure.

Missed Dose Advice

If a dose is missed, contact your doctor or healthcare provider immediately to determine when to schedule the next dose. Do not wait for the usual dosing interval to pass.

Driving Precautions

This medication may cause drowsiness, dizziness, or blurred vision, which can impair your ability to drive or operate machinery. Exercise caution until you know how it affects you.