Posology : מינונים

4.2     Posology and method of administration
Adults
Dosage and interval between injections should be adjusted for each individual patient so as to achieve a maximum suppression of psychotic symptoms with a minimum of side effects.

Flupentixol decanoate 20 mg/ml
In the maintenance treatment the dosage range would normally be 20-40 mg (1-2 ml) at intervals of 2 to 4 weeks depending on the response.
Some patients may need larger doses or need them at shorter intervals. Flupentixol decanoate 20 mg/ml is unsuitable for patients in whom sedation is required. Injection volumes larger than 2 ml should be distributed between two injection sites.

If volumes larger than 2-3 ml of the 20 mg/ml solution are required the more concentrated solutions (flupentixol decanoate 100 mg/ml) should be preferred.

During an exacerbation or acute relapse of the illness single injections of as much as 400 mg fortnightly (or in the occasional cases weekly for a short period) may be required.

Flupentixol decanoate 100 mg/ml
Dosage range lies between 50 mg (0.5 ml) every 4 weeks to 300 mg (3 ml) every 2 weeks but some patients may require up to 400 mg (4 ml) weekly. Injection volumes larger than 2 ml should be distributed between two injection sites.

Adequate control of severe psychotic symptoms by the concentrated injection fluids is usually achieved within 4 to 6 months and may justify gradual return to lower dose maintenance.
When changing the medication from oral flupentixol to maintenance treatment with flupentixol decanoate the following guidelines should be used:
 x mg p.o. daily corresponds to 4x mg decanoate every 2 weeks.
x mg p.o. daily corresponds to 8x mg decanoate every 4 weeks.

Oral flupentixol should be continued during the first week after the first injection but in diminishing dosage.

Patients being transferred from other depot preparations should receive a dose in the ratio of 40 mg flupentixol decanoate equivalent to 25 mg fluphenazine decanoate, to 200 mg zuclopenthixol decanoate, or to 50 mg haloperidol decanoate.

Subsequent doses of flupentixol decanoate and interval between injections should be adjusted to the patient's response.

Older patients
Older patients should receive dosages in the lower end of the dosage range.

Reduced renal function
Flupentixol decanoate can be given in usual doses to patients with reduced renal function.
Reduced liver function
Careful dosing and, if possible, a serum level determination is advisable.

Children
Flupentixol decanoate is not recommended for use in children due to lack of clinical experience.

Method of administration
Flupentixol decanoate is administered by intramuscular injection into the upper outer quadrant of the gluteal region. Injection volumes exceeding 2 ml should be distributed between two injection sites. Local tolerability is good.