Thiothixene

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Laboratory 9 Mechanism-of-action 10 More General Terms 11 Additional Terms 12 Internet Database 13 References

Introduction

• Tradename: Navane. (thiothixene hydrochloride)

Indications

• symptomatic management of psychotic disorders

Contraindications

• narrow-angle glaucoma
• bone marrow suprression
• severe liver disease
• severe cardiac disease

• Caution:

• safety & efficacy in children < 6 months of age is not established
• seizures
  

• pregnancy category = c
• safety in lactation = ?

Dosage

• 4 mg IM every 6-12 hours
• start 2 mg PO TID, max 60 mg/day.

• Tabs: 1, 2, 5, 10, 20 mg.
• Liquid: 5 mg/5 mL.

Pharmacokinetics

• oral dose is well absorbed from GI tract
• widely distributed throughout body tissues
• metabolized by the liver
• excreted unchanged in the feces
• elimination 1/2life is 30 hours
• residual drug remains in body for several weeks
  

• elimination via liver
• elimination via kidney
• 1/2life = 34 hours

Adverse-effects

• common (> 10%)

• pseudoparkinsonism, akathisia, dystonia, hypotension, pigmentary retinopathy, persistent tardive dyskinesia, constipation, decreased sweating, dizziness, orthostatic hypotension, nasal congestion

• less common (1-10%)

• difficulty urinating, photosensitivity, rash, changes in menstrual cycle, sexual dysfunction, breast pain, weight gain, nausea/vomiting, epigastric pain, trembling of fingers

• uncommon (< 1%)

• agranulocytosis, cholestatic jaundice, neuroleptic malignant syndrome, priapism, blue-gray discoloration of skin, impairment of temperature regulation, galactorrhea, leukopenia, hepatotoxicity, changes in the cornea & lens, pigmentary retinopathy

• other

• low sedation, anticholinergic effects & orthostatic hypotension
• high incidence of extrapyramidal effects

• tardive dyskinesia
• pseudoparkinsonism
• dystonias
• akathisia

• neuroleptic malignant syndrome (rare)
• prolongation of the QT interval
• elevated serum transaminases
• lowering of seizure threshold
  
• drug adverse effects of antipsychotic agents

Drug-interactions

• (see chlorpromazine)
  
• drug interaction(s) of antipsycotics with benzodiazepines

Laboratory

• specimen: serum
• methods: color, fluorometry, GC-MS, HPLC
• interferences: color & fluorometric methods lack specificity

Mechanism-of-action

• high potency antipsychotic agent (see chlorpromazine)

More General Terms

• thioxanthene
• antipsychotic agent

Additional Terms

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

Internet Database

PubChem: 5454
PubChem: 941650
PubChem: 941651
PubChem: 64754
PubChem: 64755

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
4. Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed, WB Saunders, Philadelpha 1995

thiothixene (Navane, Tiotixene)