May alter cardiac conduction (avoid use in underlying QT prolongation, in patients taking medicines which prolong the QT interval, or cause polymorphic ventricular tachycardia). May cause anticholinergic effects (use with caution in decreased GI motility, paralytic ileus, urinary retention, BPH, xerostomia, or visual problems). Myelosuppression (e.g. leukopenia, agranulocytosis) observed with antipsychotic use (use contraindicated in bone marrow suppression). Esophageal dysmotility or aspiration are possible (use with caution in risk of pneumonia). May cause extrapyramidal symptoms, including acute dystonic reactions, akathisia, pseudoparkinsonism, and tardive dyskinesia. Neuroleptic malignant syndrome might occur. May cause orthostatic hypotension (use with caution in cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). Pigmentary retinopathy might occur. May cause sedation. Impaired core body temperature regulation might occur (caution with strenuous exercise, heat exposure, dehydration, and concomitant medication possessing anticholinergic effects). Use with caution in severe cardiovascular disease, narrow-angle glaucoma, hepatic impairment, myasthenia gravis (may be exacerbated by cholinergic blockade), Parkinson’s disease (may be more sensitive to adverse effects), breast cancer or other prolactin-dependent tumors (elevates prolactin levels), renal impairment, respiratory disease, or in patients at risk of seizures. Elderly patients with dementia-related psychosis treated with antipsychotics are at increased risk of death. Flupenthixol not approved for this indication. May mask toxicity of other drugs or conditions (e.g. intestinal obstruction, Reye’s syndrome, brain tumor) due to antiemetic effects.