Molindone

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Mechanism-of-action 9 More General Terms 10 Additional Terms 11 Internet Database 12 References

Introduction

• Tradename: Moban.

Indications

• symptomatic management of psychotic disorder

Contraindications

• narrow angle glaucoma
• bone marrow depression
• CNS depression
• liver disease

• Caution:

• cardiovascular disease
• seizure disorder
  

• pregnancy category = c
• safety in lactation = ?

Dosage

• start 25 mg PO TID
• adjust in 3-4 days as needed
• start elderly on lower dose
• max 225 mg/day
• doses of 400 mg/day have been used

• Tabs: 5, 10, 25, 50, 100 mg.
• Liquid: 20 mg/mL.

Pharmacokinetics

• rapidly & completely absorbed from the GI tract
• rapidly metabolized in the liver to inactive metabolites
• < 3% excreted unchanged in the urine
  

• elimination via liver
• elimination via kidney

Adverse-effects

• common (> 10%)

• akathisia, extrapyramidal effects, persistent tardive dyskinesia, blurred vision, constipation, decreased sweating, dry mouth, orthostatic hypotension

• less common (1-10%)

• depression, change in menstrual cycle, breast swelling

• uncommon (< 1%)

• tachycardia, arrhythmias, sedation, drowsiness, restlessness, anxiety, seizures, altered temperature regulation, neuroleptic malignant syndrome, hyperpigmentation, pruritis, rash, galactorrhea, gynecomastia, weight gain, dry mouth, agranulocytosis*, leukopenia#, retinal pigmentation, photosensitivity

• other

• low sedation, anticholinergic & orthostatic hypotensive effects
• extrapyramidal symptoms (moderate)

• tardive dyskinesia
• pseudoparkinsonism
• dystonias
• akathisia

• neuroleptic malignant syndrome (rare)
• QT prolongation
• direct myocardial suppression

• * agranulocytosis is more common in women between 4th & 10th week of therapy
• # leukopenia generally occurs with large doses for prolonged periods
  

• drug adverse effects of antipsychotic agents

Drug-interactions

• see chlorpromazine
• molindone tablets contain CaSO4 & may inhibit absorption of:

• phenytoin
• tetracyclines
• quinolones
  

• drug interaction(s) of antipsycotics with benzodiazepines

Mechanism-of-action

• intermediate potency antipsychotic agent
• relatively selective domapine D2 receptor antagonist
• see chlorpromazine

More General Terms

• antipsychotic agent

Additional Terms

• chlorpromazine (Thorazine, Ormazine, Propaphenin, Sonazine, Chloractil)

Internet Database

PubChem: 23897
PubChem: 27421
PubChem: 522521

References

1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
3. Kaiser Permanente Northern California Regional Drug Formulary, 1998

molindone (Moban, Lindone)