Thioridazine (HCl)

Thioridazine (HCl) is a phenothiazine, similar to chlorpromazine. Thioridazine (HCl) is used in the treatment of certain mental disorders such as psychosis, confusion and agitation.


Adult Dose
Dose: 50 to 300 mg
Single Dose: 180 (175)
Frequency: 24 hourly
Route: PO
Instructions: For psychotic out patients.
Neonatal
Dose: 0.5 mg/kg
Single Dose: 0.5 (0.5)
Frequency: 12 hourly
Route: Oral
Instructions:
Paedriatic
Dose: 0.5 to 2 mg/kg
Single Dose: 1.2 (1.25)
Frequency: 12 hourly
Route: Oral
Instructions: -
Characteristics
. It is of Synthetic origin and belongs to Phenothiazine. It belongs to D2 antagonist pharmacological group on the basis of mechanism of action and also classified in Psychotherapeutic Drugs pharmacological group.The Molecular Weight of Thioridazine (HCl) is 407.00. Its pKa is 9.5.
Contraindications
Thioridazine (HCl) is contraindicated in conditions like Blood dyscrasias,Coma,Cardiovascular disease,CNS depression.
Effects
The severe or irreversible adverse effects of Thioridazine (HCl), which give rise to further complications include Tardive dyskinesia, Acute dyskinesia, Pigmentory retinopathy.Thioridazine (HCl) produces potentially life-threatening effects which include Agranulocytosis, Arrhythmias, Neuroleptic Malignant Syndrome, Cardiac Arrest. which are responsible for the discontinuation of Thioridazine (HCl) therapy.The signs and symptoms that are produced after the acute overdosage of Thioridazine (HCl) include Hypotension, Cardiac arrhythmias, Coma, Epileptic seizures, Loss of reflexes, Shallow breathing, Motor restlessness, Hyperflexia.The symptomatic adverse reactions produced by Thioridazine (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Drowsiness, Tachycardia, Constipation, Dry mouth, Blurred vision, Urinary retensionX, Termors, Sedation, Postural hypotension, Nasal congestion, Sexual dysfunction.
Indications
Thioridazine (HCl) is primarily indicated in conditions like Anxiety, Hypomania, Mania, Psychosis, Schizophrenia, and can also be given in adjunctive therapy as an alternative drug of choice in Epilepsy, Schizophrenia and other psychoses.
Interactions
Thioridazine (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineAlcoholAmitriptyline (HCl)coadministration of these two drugs can cause increase in plasma concentration of both drugs that result in central nervous system depression,hypotension and prolong QT interval.ModerateCombine use of these drugs should be avoided.AtenololBoth agents act additively and produce hypotensive and central nervous system depressant effect.ModerateClosely monitor for hypotension and prolonged CNS depression. Patient should notify to physician about excessive side effects.Dapoxetine HCl Dapoxetine inhibits the metabolism of thioridazine and the resulting elevated levels of thioridazine are expected to augment the prolongation of the QTc interval.Dapoxetine should not be used in combination with thioridazine DextromethorphanDisopyramideprolongs QT interval results in ventricular arrhythmias, ventricular tachycardia and torsade de pointes. prolongs QT interval results in ventricular arrhythmias, ventricular tachycardia and torsade de pointes. prolongs QT interval results in ventricular arrhythmias, ventricular tachycardia and torsade de pointes. Thioridazine prolongs QT interval results in ventricular arrhythmias, ventricular tachycardia and torsade de pointes. MajorCoadministration is considered contraindicatedDroperidolFosphenytoinGuanethidineLevodopaLithiumCoadministration may initiate the number of neurologic and psychiatric symptoms such as extrapyramidal effects, seizures, change in mental status, delirium, fever etcModerateClosely monitor the patient for changed efficacy and safety. Discontinue one or both agents if necessary.Maprotiline (HCl)Thioridazine and maprotiline both prolong QT interval result in increasedrisk of ventricular arrythmia.MajorCoadministration of these agents is considered contraindicated.Mibefradil (Di HCl)NaltrexoneLethargy and somnolence have been reported following concurrent use.ModerateParoxetinearoxetine increases the plasma concentration of thioridazine.result in increasedtoxicity such as ventricular arrythmia, ventricular tachycardia, torsade depointes, cardiac arrest and sudden death.MajorCombination is considered contraindicated.PentamidineThioridazine and pentamidine both prolongs QT interval result in increased risk of ventricular arrythmia. MajorCoadministration of these agents is considered contraindicated.Phenylpropanolamine (HCl)Thioridazine antagonize the pharmacological effects of phenylpropanolamine. Conversely, phenylpropanolamine decreases the neuroleptic efficacy of thioridazine.ModerateCoadministration is considered contraindicated.Propranolol (HCl)ProtirelinQuetiapineQuinidineTrazodone (HCl)Coadministration of thioridazine and trazodone produce additive hypotensive effects by blockin alpha-1 adrenergic receptors.ModerateInitial dose should kept lower.Closely monitor the patient for adverse effects such as hypotension and tachycardia.VORICONAZOLEAdditive QTc prolongation may occur. Concomitant use is contraindicated. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Frings method for measuring urinary Alkaloids and Barbiturates Trindes Method for measuring Urinary Salicylate Urinary Tests for Pregnancy
Risks
Drug should not be given to Pregnant Mothers, Cardiac / Hypertensive Patients, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store in a well closed container, Below 40°C. Protect from Sunlight.
Warnings
Thioridazine should be used with caution in patients exposed to extreme heat or phosphorus insecticides, patients in state of alcohol withdrawal, patients with history of peptic ulcer, allergic reactions, with renal (kidney) impairment, prostatic hypertrophy. Photosensitization may occur, caution patients against exposure to sunlight or UV light. Discontinue use atleast 48 hr before myelography.
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