trifluoperazine (Stelazine, discontinued) 

Trifluoperazine is an oral antipsychotic medication used for the management of schizophrenia. Trifluoperazine is one of the older, first-generation antipsychotic medications. Examples of other first-generation antipsychotics include:

• prochlorperazine (Compazine, Compro, Procomp)
• chlorpromazine (Promapar, Thorazine)
• perphenazine (Trilafon)
• thioridazine (Mellaril)

Although the exact mechanism of antipsychotics is unknown, scientists believe that they may work by blocking the action of dopamine in the brain. Dopamine is a neurotransmitter (chemical) that nerves use to communicate with one another. Trifluoperazine is used when patients do not respond to other antipsychotics.

What brand names are available for trifluoperazine?

N/A

Is trifluoperazine available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for trifluoperazine?

Yes

Trifluoperazine causes extrapyramidal side effects such as:

• Abnormal muscle contractions
• Difficulty breathing and swallowing
• Neck spasms
• Other side effects include:
• Low blood pressure
• Constipation
• Dry mouth
• Blurred vision
• Seizures
• Dizziness
• Drowsiness
• Urinary retention
• Worsening of glaucoma
• Increased or decreased blood glucose

Tardive dyskinesia and neuroleptic malignant syndrome can result from trifluoperazine treatment. These side effects can be severe enough that patients must seek medical help. Neuroleptic malignant syndrome is a medical emergency.

The recommended starting dose of trifluoperazine for treating schizophrenia is 1 to 5 mg every 12 hours. The typical maintenance dose is 15 to 20 mg daily, and the maximum daily dose is 40 mg.

The dose for treating anxiety is 1 to 2 mg every 12 hours. The maximum dose is 6 mg daily. Trifluoperazine should not be used to treat anxiety for longer than 12 weeks.

Combining trifluoperazine with medications such as procainamide (Pronestyl), sotalol (Betapace), amiodarone (Cordarone), and dofetilide (Tikosyn) that affect heart rate and rhythm can cause abnormal heart beats.

Antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), and and tricyclic antidepressants may reduce the break down of trifluoperazine, leading to increased blood levels and more side effects of trifluoperazine.

Trifluoperazine should be used with caution with medications that depress the central nervous system and cause sedation or drowsiness. Examples include alprazolam (Xanax), lonazepam (Klonopin), zolpidem (Ambien), codeine, morphine, and alcohol. Such combinations can cause excessive sedation, drowsiness, weakness, confusion, speech impairment, and in severe cases coma or death. Combining alcohol with trifluoperazine also increases the risk of low blood pressure.

Use of trifluoperazine during pregnancy has not been adequately studied. Neonates exposed to antipsychotics during the third trimester of pregnancy are at risk for extrapyramidal and withdrawal symptoms after birth. Symptoms reported included agitation, hypertonia, hypotonia, tremor, somnolence, depressed breathing, and feeding disorder.

Safe use of trifluoperazine by nursing mothers has not been established.

What preparations of trifluoperazine are available?

Tablets: 1, 2, 5 and 10 mg.

How should I keep trifluoperazine stored?

Trifluoperazine tablets should be stored between 15 C and 30 C (59 F and 86 F).