- Stock: In Stock
- Brand: Incepta Pharmaceuticals
- Product ID: Fluphenazine Decanoate
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Fenazine 25mg/ml Injection — Fluphenazine Decanoate | Beximco Pharmaceuticals
| Generic Name | Fluphenazine Decanoate 25mg/ml |
| Drug Class | Typical (First-Generation) Antipsychotic — Phenothiazine Depot |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Route | Deep Intramuscular Injection (Depot) |
| Duration of Action | 2–4 weeks per dose |
| Prescription Status | Prescription Only — Psychiatrist/Specialist |
Overview
Fenazine 25mg/ml is a long-acting depot formulation of Fluphenazine Decanoate, a first-generation (typical) antipsychotic. The decanoate ester is slowly hydrolysed after deep IM injection, releasing fluphenazine over 2–4 weeks. This eliminates the need for daily oral dosing and significantly improves treatment adherence in patients with schizophrenia and other psychotic disorders. It is administered by a healthcare professional at scheduled intervals.
Mechanism of Action
Fluphenazine is a potent dopamine D2 receptor antagonist in the mesolimbic and mesocortical pathways. Blockade of D2 receptors reduces positive symptoms of psychosis (hallucinations, delusions, thought disorder). It also has activity at alpha-adrenergic, muscarinic, and histaminergic receptors, accounting for its side effect profile. The decanoate ester prolongs action by creating a tissue depot from which the drug is slowly released and hydrolysed.
Indications
- Maintenance treatment of schizophrenia
- Schizoaffective disorder — maintenance phase
- Other chronic psychotic disorders requiring long-term antipsychotic treatment
- Patients with poor compliance on oral antipsychotics
Dosage
| Patient | Dose | Interval | Notes |
|---|---|---|---|
| Initial (test dose) | 12.5mg (0.5ml) | Single dose | Observe for 24–72 hours for adverse effects before maintenance |
| Maintenance (typical) | 12.5–100mg (0.5–4ml) | Every 2–4 weeks | Titrated by psychiatrist based on response |
| Elderly | Start with lower dose | Every 4 weeks | Increased sensitivity to EPS and sedation |
Administered by deep IM injection into the gluteal muscle by a healthcare professional only. Never self-administer.
Critical Diabetic Patient Warnings
- Hyperglycaemia and new-onset diabetes: Typical antipsychotics including fluphenazine can cause glucose dysregulation and worsen glycaemic control in diabetics — monitor fasting blood glucose regularly
- Weight gain: Antipsychotic-associated weight gain worsens insulin resistance — monitor weight and BMI; optimise diet and exercise
- Metabolic syndrome risk: Monitor lipid profile, blood glucose, waist circumference, and blood pressure at baseline and every 3–6 months
- Diabetic hypotension: Fluphenazine causes orthostatic hypotension — combined with autonomic neuropathy in diabetics, fall risk is significant; advise slow position changes
- Tardive dyskinesia vs. diabetic movement disorders: Distinguish antipsychotic-induced movement disorders from diabetic peripheral neuropathy symptoms
Side Effects
| System | Side Effect | Severity |
|---|---|---|
| Neurological (EPS) | Dystonia, akathisia, Parkinsonism, tardive dyskinesia | Common — Serious |
| Endocrine | Hyperprolactinaemia (amenorrhoea, galactorrhoea, gynaecomastia) | Common |
| Metabolic | Weight gain, hyperglycaemia, dyslipidaemia | Moderate |
| Cardiovascular | Orthostatic hypotension, QT prolongation (rare) | Moderate |
| Anticholinergic | Dry mouth, constipation, urinary retention, blurred vision | Mild–Moderate |
| CNS | Sedation, fatigue | Mild |
| Serious (rare) | Neuroleptic Malignant Syndrome (NMS) — fever, rigidity, autonomic instability | Life-threatening |
Drug Interactions
| Drug/Class | Interaction |
|---|---|
| Antihypertensives | Additive hypotension — use with caution |
| CNS depressants (opioids, benzodiazepines) | Additive CNS depression |
| Anticholinergics | Additive anticholinergic effects |
| Antidiabetic drugs | Fluphenazine may impair glucose control — adjust antidiabetic doses |
| QT-prolonging drugs | Increased risk of arrhythmia — avoid combinations |
| Levodopa | Mutual antagonism — avoid in Parkinson's patients |
Contraindications
- Known hypersensitivity to fluphenazine or phenothiazines
- Comatose or severely CNS-depressed states
- Severe hepatic disease
- Bone marrow depression or blood dyscrasias
- Parkinson's disease
- Phaeochromocytoma
Storage
Store at 15–25°C. Protect from light. Do not freeze. Keep in original packaging until use. For single patient use only — do not share ampoules.
Frequently Asked Questions
Q: Why use a depot injection instead of daily tablets?
A: Depot injections ensure consistent medication delivery, eliminate daily pill burden, and significantly improve adherence — a major advantage in long-term schizophrenia management where missed doses lead to relapse.
Q: How often is the injection given?
A: Typically every 2–4 weeks, determined by the psychiatrist based on clinical response. The interval is strictly scheduled and must be maintained.
Q: Does this injection affect diabetes?
A: It can. Fluphenazine may worsen glycaemic control. Diabetic patients on this medication require regular blood glucose and metabolic monitoring. Discuss any changes in blood sugar with your physician and psychiatrist.
Medical Disclaimer: Fenazine 25mg/ml Injection (Fluphenazine Decanoate) is a prescription-only specialist medicine administered exclusively by healthcare professionals. Diabetic patients require enhanced metabolic monitoring including blood glucose, lipids, and blood pressure. Any signs of Neuroleptic Malignant Syndrome (fever, rigidity, confusion) require immediate emergency care. This information is for educational purposes only and does not constitute medical advice. Always follow your psychiatrist's instructions.
