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Fluphenazine is a phenothiazine derivative (piperazine) used in the treatment of psychotic disorders. Its dose in milligrams equivalent to 100 mg of chlorpromazine is 0.6−1.2 mg. A statistical evaluation1 of clinical studies found the near maximal effective dose of oral fluphenazine to be <6.9 mg/day. For the decanoate, the near-maximal effective dose was 25 mg/two weeks. As a high potency antipsychotic, it may have a high potential for causing extrapyramidal side effects. This would be in addition to the usual adverse effects of antipsychotic drugs (neurologic, anticholinergic, hypotension). Elderly patients should be observed for these occurrences. The half-life of fluphenazine is formulation-dependent. (The decanoate is 5 to 12 days; the hydrochloride 12 to 60 hours.) Fluphenazine is also used to alleviate pain and in childhood development disorders.
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Therapeutic: 1.0−10.0 ng/mL
Time to maximum blood concentration after intramuscular injection of fluphenazine enanthate was two to four days, and the plasma half-life was 3.6 and 3.7 days in two patients compared to two to four hours and about 12 hours, respectively, for fluphenazine hydrochloride. Time to maximum blood concentration after intramuscular injection of the decanoate salt was 12 to 24 hours, and plasma half-life was 6.8 and 9.6 days in two patients.
Serum or plasma
Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.
Transfer serum or plasma to a transport tube with plastic stopper within 45 minutes of collection.
Causes for Rejection
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|706887||Fluphenazine (Prolixin(R)), S||3650-9||706887||Fluphenazine (Prolixin(R)), S||ng/mL||3650-9|