FLUPENTIXOL DECANOATE INJECTION (Depixol’)
Flu - pen - thick - sol de - can - o - ate
Why have I been prescribed flupentixol?
Flupentixol (or flupenthixol) is used to treat schizophrenia and similar conditions, such as psychosis.
When they have schizophrenia, many people hear voices talking to them or about them. They may also become suspicious
or paranoid. Some people also have problems with their thinking and feel that other people can read their thoughts. These
are called "positive symptoms". Flupentixol can help to relieve these symptoms. Many people with schizophrenia also
experience "negative symptoms". They feel tired and lacking in energy and may become quite inactive and withdrawn.
Flupentixol may help relieve these symptoms as well. Flupentixol is also useful to help manage agitation, anxiety, mania or
hypomania and some other conditions.
What exactly is flupentixol?
Schizophrenia and similar disorders are sometimes referred to as psychoses, hence the name given to this group of
medicines, which is the “antipsychotics”. They are sometimes also called the neuroleptics or (incorrectly) major
tranquillisers. Flupentixol (or flupenthixol, as it used to be called) decanoate is an antipsychotic. It is a depot injection that is
a long-acting form of the medication. When injected into a muscle, it creates a store or “depot” and is released slowly into
the body over several weeks. Flupenthixol is the active drug. The decanoate is an inactive part that helps dissolve the
flupenthixol in the oil for the injection.
The brand or trade name of flupentixol is ‘Depixol’.
Is flupentixol safe to have?
It is usually safe to have flupentixol depot injections regularly as prescribed by your doctor, but it doesn’t suit everyone. Let
your doctor know if any of the following apply to you, as extra care may be needed:
a) If you have epilepsy, diabetes, Parkinson’s disease or glaucoma, or suffer from heart, liver, kidney, thyroid or prostate
trouble;
b) If you are taking any other medication. This includes medicines from your pharmacist, such as antihistamines;
c) If you are pregnant, breast feeding, or wish to become pregnant.
What is the usual dose of flupentixol?
The test dose is 20mg. The usual dose can vary from 20mg to 400mg a week. Injections are usually given every two
weeks, but can be given every three or four weeks.
How is flupentixol given?
First of all, a test dose of flupentixol (which is a very low dose) is given to see how your body copes with it. Then you will be
given regular injections. The injection is given deep into the buttock or thigh muscle. The injection can be given by a CMHN
(Community Mental Health Nurse) or by your GP’s practice nurse. The dose will depend on your symptoms and side
effects.
What happens if I miss an injection?
You should contact your nurse/doctor as soon as you remember. They will probably arrange for another injection to be
given to you.
When I feel better, can I stop having my injections?
No. If you stop having flupentixol, your original symptoms may return, but this may not be for 3 to 6 months after you stop
the drug. You and your doctor should decide together when you can come off it. Most people need to be on flupentixol for
quite a long time, sometimes years. Flupentixol is not addictive.
What will happen to me when I start flupentixol injections?
Antipsychotics do not work straight away. For example, it may take several days or even weeks for some of the symptoms
to reduce. To begin with, most people find that this medication will help them feel more relaxed and calm. Later, after one
or two weeks, other symptoms should begin to improve.
Unfortunately, you might get some side effects before you start to feel any better. Most side effects should go away after a
few weeks. Look at the table over the page. It tells you what to do if you get any of the usual side effects. Not everyone will
get the side effects shown. There are many other possible side effects. Ask your pharmacist, doctor or nurse if you are
worried about anything else that you think might be a side effect.
Side effect What is it? What should I do if it happens to me?
COMMON
AKATHISIA You feel restless, unable to feel comfortable
unless you are moving.
Tell your doctor about this. It may be possible to change your drug
or dose, or give you something to reduce these feelings.
MOVEMENT
DISORDERS
Feeling shaky or having a tremor. Your neck
may twist back. Your eyes and tongue may
move on their own.
It is not usually dangerous. If it is bad or worries you, tell your
doctor. He or she can give you something for it.
RAISED
PROLACTIN
Prolactin is a natural chemical we all have.
High levels can affect periods in women or
cause impotence in men. It may also cause
breast tenderness and milk secretion, in men
as well as women.
This sometimes wears off in a few weeks, but discuss this with
your doctor anyway. It may be that a change in dose or different
drug will help.
WEIGHT GAIN Eating more and putting on weight. Avoid fatty foods like chocolate, crisps and fizzy drinks. A diet full
of vegetables and fibre will usually help, as will physical activities
such as walking. If it becomes a problem or you are worried, ask
to see a dietician.
LESS COMMON
DROWSINESS Feeling sleepy or sluggish. Don’t drive or use machinery. As your treatment continues you
should feel less drowsy.
UNCOMMON
Dry mouth. Not much saliva or spit. Sugar-free boiled sweets, chewing gum or eating citrus fruits
usually helps. If not, your doctor can give you a mouth spray. A
change in medicine or dose may be possible.
Blurred vision Things look fuzzy and you can’t focus properly. See your doctor if
you are worried. You won’t need glasses.
Feeling "bunged up" inside. You can't pass a
motion or stool.
Eat more fibre e.g. bran, fruit and vegetables. Do more walking.
Make sure you drink plenty of fluid. A mild laxative from a
pharmacy might help.
ANTI-
CHOLINERGIC
EFFECTS
Difficulty in passing urine Contact your doctor now.
SEXUAL
DYSFUNCTION
Finding it hard to have an orgasm. No desire
for sex. Men can become impotent.
Discuss this with your doctor when you next meet.
SWELLING
AND NODULES
Injection site swells. It feels painful and
lumpy.
Report it to your nurse. Warm baths and regular exercise like
walking can help.
RARE
HYPOTENSION A low blood pressure. You may feel faint
when you stand up.
Try not to stand up too quickly. If you feel dizzy, don’t drive. This
dizziness is not dangerous
VERY RARE
NMS Neuroleptic Malignant Syndrome includes a
high body temperature, muscle stiffness and
being unable to move.
It usually occurs within a few weeks of a dose change. Contact
your doctor immediately. Keep cool, with fans or cool water.
What about alcohol?
It is officially recommended that people taking flupentixol should not drink alcohol. This is because both flupentixol and alcohol can
cause drowsiness. If the two are taken at the same time, severe drowsiness can result. This can lead to falls or accidents. As well as
this, drinking alcohol often makes psychosis worse. Excessive drinking is especially likely to do this. Once people are used to taking
medication, they can sometimes drink alcohol in small amounts without any harm. Avoid alcohol altogether for the first one or two
months. After this, if you want a drink, try a glass of your normal drink and see how you feel. If this doesn’t make you feel drowsy, then
it is probably OK to drink small amounts. It pays to be very cautious because alcohol affects people in different ways, especially when
they are taking medication.
Don't stop taking your medication because you fancy a drink. Discuss any concerns you may have with your doctor, pharmacist or
nurse. If you do drink alcohol, drink only small amounts. Never drink any alcohol and drive.
Remember, leaflets like this can only describe some of the effects of medication. You may find other
books or leaflets also useful. If you have access to the internet you may find a lot of information
there as well, but be careful, as internet based information is not always accurate.
2001 United Kingdom Psychiatric Pharmacy Group www.ukppg.org.uk
This leaflet is to help you understand about your medicine. It is not an official manufacturer's Patient Information Leaflet.
For more information call the UKPPG National Telephone Helpline, 11am to 5pm, Monday to Friday on 020 7919 2999 or
visit www.nmhct.nhs.uk/pharmacy
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