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NERVOUS SYSTEM › PSYCHOLEPTICS › ANTIPSYCHOTICS › Phenothiazines with piperidine structure
pipotiazine
N05AC04
Forms & Strengths
- Pipotiazine palmitate injection: 25 mg/mL
- Pipotiazine palmitate injection: 50 mg/mL
- Oral liquid formulations (varies by region)
Adult Dosing
- Schizophrenia and chronic psychoses (intramuscular palmitate): Initial test dose of 25-50 mg
- Maintenance dose: 50 to 100 mg administered every 4 weeks via deep intramuscular injection
- Maximum dose: Up to 200 mg every 4 weeks based on clinical response and tolerability
Pediatric Dosing
- Safety and efficacy in pediatric patients under 18 years of age have not been established
- Use in children and adolescents is generally not recommended
Indications
- Management of chronic schizophrenia
- Maintenance treatment of chronic psychotic disorders in stable adult patients
Mechanism of Action
- Long-acting phenothiazine antipsychotic
- Blocks postsynaptic dopamine D2 receptors in the mesolimbic and mesocortical pathways
- Exhibits varying degrees of alpha-1 adrenergic, muscarinic cholinergic, and histaminergic receptor antagonism
Contraindications
- Known hypersensitivity to pipotiazine or other phenothiazines
- Severe central nervous system depression or comatose states
- Circulatory collapse or severe cardiovascular disease
- History of bone marrow depression or blood dyscrasias
Adverse Reactions
- Extrapyramidal symptoms including akathisia, dystonia, and parkinsonism
- Tardive dyskinesia with long-term use
- Sedation, dizziness, and headache
- Anticholinergic effects such as dry mouth, blurred vision, and urinary retention
- Orthostatic hypotension and QT prolongation
- Hyperprolactinemia leading to galactorrhea, amenorrhea, or sexual dysfunction
Drug Interactions
- CNS depressants (alcohol, opioids, sedatives): Enhanced sedation and respiratory depression
- Antihypertensive agents: Increased risk of severe hypotension
- Drugs prolonging the QT interval (antiarrhythmics, certain antibiotics): Increased risk of ventricular arrhythmias
- Levodopa and dopamine agonists: Mutual antagonism of therapeutic effects
Curated Content: Needs Vetting Before Put to Clinical Use