Active Ingredient: Zuclopenthixol
For this indication, competent medicine agencies globally authorize below treatments:
Oral, 20 milligrams zuclopenthixol, divided daily. Afterwards, oral, between 75 milligrams zuclopenthixol and 150 milligrams zuclopenthixol, divided daily. The maximum allowed total dose is 150 milligrams zuclopenthixol daily.
The dosage range is 4-150 mg/day in divided doses. The usual initial dose is 20-30 mg/day (sometimes with higher dosage requirements in acute cases), increasing as necessary. The usual maintenance dose is 20-50 mg/day.
Maximum dosage per single dose is 40 mg.
When transferring patients from oral to depot antipsychotic treatment, the oral medication should not be discontinued immediately, but gradually withdrawn over a period of several days after administering the first injection.
In accordance with standard medical practice, initial dosage may need to be reduced to a quarter or half the normal starting dose in the frail or older patients.
Regimen A: Intramuscular, between 50 milligrams zuclopenthixol and 150 milligrams zuclopenthixol, once every 2 to 3 days, over the duration of 2 weeks. Afterwards, oral, between 40 milligrams zuclopenthixol and 150 milligrams zuclopenthixol, divided daily. The maximum allowed total dose is 150 milligrams zuclopenthixol daily.
Regimen B: Intramuscular, between 50 milligrams zuclopenthixol and 150 milligrams zuclopenthixol, once every 2 to 3 days, over the duration of 2 weeks. Afterwards, intramuscular, between 200 milligrams zuclopenthixol and 400 milligrams zuclopenthixol, once every 2 weeks.
Dosage should be adjusted according to the severity of the patient’s illness.
The usual dosage is 50-150 mg (1-3 ml) zuclopenthixol acetate, repeated if necessary after 2 or 3 days. Some patients may need an additional injection between 1 and 2 days after the first injection.
Zuclopenthixol acetate is not intended for long-term use and duration of treatment should not be more than two weeks. The maximum accumulated dosage should not exceed 400 mg and the number of injections should not exceed four.
Maintenance treatment where required can be continued with zuclopenthixol tablets or zuclopenthixol decanoate injection, according to the following guidelines:
1. Introduce zuclopenthixol tablets at a dosage of 20-60 mg/day in divided doses, 2 to 3 days after the last injection of zuclopenthixol acetate. If necessary increase the tablet dosage by 10-20 mg each day up to a maximum of 150 mg/day.
2. Concomitantly with the last injection of zuclopenthixol acetate, administer 200-400 mg of zuclopenthixol decanoate injection by deep intramuscular injection and repeat the zuclopenthixol decanoate injection at intervals of 2 to 4 weeks. Higher dosages or a shorter interval may be necessary.
The dosage may need to be reduced in older patients owing to reduced rates of metabolism and elimination. Maximum dosage per injection should be 100 mg.
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