Posology : מינונים

4.2   Posology and method of administration

Posology
Adults
Dosage should be individually adjusted according to the condition of the patient.

The dose range would normally be 50-150 mg (1-3 ml) i.m., repeated if necessary, preferably with a time interval of 2 to 3 days. In a few patients an additional injection may be needed 24 to 48 hours following 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 in a course should not exceed 400 mg and the number of injections should not exceed four.

In the maintenance therapy, treatment should be continued with oral zuclopenthixol or zuclopenthixol decanoate i.m., after the following guidelines:

1) Change to oral zuclopenthixol
2 to 3 days after the last injection of zuclopenthixol acetate a patient who has been treated with 100 mg zuclopenthixol acetate, should be started at an oral dosage of about 40 mg daily, possibly in divided dosages. If necessary the dose can be further increased by 10-20 mg every 2 to 3 days up to 75 mg daily or more.

2) Change to zuclopenthixol decanoate
Concomitantly with the (last) injection of zuclopenthixol acetate (100 mg), 200-400 mg (1-2 ml) of zuclopenthixol decanoate 200 mg/ml should be given intramuscularly and repeated every 2nd week. Higher doses or shorter intervals may be needed.

Zuclopenthixol acetate and zuclopenthixol decanoate can be mixed in a syringe and given as one injection (co-injection).

Subsequent doses of zuclopenthixol decanoate and interval between injections should be adjusted according to the response of the patient.
Older patients
The dosage may need to be reduced in the older . Maximum dosage per injection should be 100 mg.

Children
Clopixol Acuphase is not recommended for use in children due to lack of clinical experience.

Reduced renal function
Clopixol Acuphase can be given in usual doses to patients with reduced renal function.

Reduced liver function
Patients with compromised hepatic function should receive half the recommended dosages and, if possible, a serum level determination is advisable.

Method of administration
Clopixol Acuphase 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.
Note: As with all oil injections it is important to ensure, by aspiration before injection, that inadvertent intravascular entry does not occur.