Molindone
- Atc Codes:N05AE02
- CAS Codes:15622-65-8#7416-34-4
- PHARMGKB ID:15622-65-8#7416-34-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
North America
USA: Moban (d).
Drug combinations
Chemistry
Molindone Hydrochloride: C~16~H~24~N~2~O~2~ HCl. Mw: 312.83. (1) 4H-Indol-4-one, 3-ethyl-1,5,6,7-tetrahydro-2-methyl-5-(4-morpholinylmethyl)-, monohydrochloride; (2) 3-Ethyl-6,7-dihydro-2-methyl-5-(morpholinomethyl)indol-4(5H)-one monohydrochloride. CAS-15622-65-8; CAS-7416-34-4 (molindone)(1967).
Pharmacologic Category
Antipsychotics, Miscellaneous. (ATC-Code: N05AE02).
Mechanism of action
Mechanism of action mimics that of chlorpromazine. However, produces more extrapyramidal symptoms and less sedation.
Therapeutic use
Management of schizophrenia.
Pregnancy and lactiation implications
Safe use during pregnancy or in lactating women not established. Drug should not be used in pregnant or nursing women unless potential benefits outweigh possible risk to woman or fetus.
Unlabeled use
Management of psychotic disorders. Behavioral symptoms associated with dementia (elderly). Psychosis/agitation related to Alzheimer’s dementia.
Contraindications
Hypersensitivity to molindone or any component of the formulation (cross-reactivity between phenothiazines may occur). Severe CNS depression. Coma.
Warnings and precautions
May alter cardiac conduction (avoid use in underlying QT prolongation, in patients taking medicines which prolong QT interval or cause polymorphic ventricular tachycardia). May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention)(use with caution in decreased gastrointestinal motility, paralytic ileus, urinary retention, benign prostatic hypertrophy, xerostomia, or visual problems). Myelosuppression (e.g. leukopenia, agranulocytosis) observed with antipsychotic use. Antipsychotic use associated with esophageal dysmotility and aspiration (use with caution in risk of pneumonia). May cause extrapyramidal symptoms, including pseudoparkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesia. Use may be associated with neuroleptic malignant syndrome. May rarely cause orthostatic hypotension (use with caution in cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). May be associated with pigmentary retinopathy. May be sedating (use with caution in disorders where CNS depression is a feature). Impaired core body temperature regulation may occur. Use with caution in severe cardiovascular disease. Molindone not approved for use in dementia-related psychosis (increased incidence of cerebrovascular adverse events, including fatalities). Use with caution in hepatic impairment, in Parkinson’s disease, in breast cancer or other prolactin-dependent tumors (elevates prolactin levels), in renal impairment, in respiratory disease, and in risk of seizures, including patients with history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy with medications which may lower seizure threshold. May mask toxicity of other drugs or conditions (e.g. intestinal obstruction, Reye’s syndrome, brain tumor) due to antiemetic effects. Due to calcium sulfate content in tablet, concomitant use may decrease absorption of phenytoin and tetracyclines. Use with caution in debilitated or elderly patients.