Pipotiazine
- Atc Codes:N05AC04
- CAS Codes:37517-26-3#39860-99-6
- PHARMGKB ID:37517-26-3#39860-99-6
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Special Considerations
Brand Names
Europe
France: Piportil; Greece: Piportyl; Ireland: Piportil; Spain: Lonserén; UK: Piportil.
North America
Canada: Piportil.
Latin America
Argentina: Piportil, Pipotiazina; Brazil: Piportil; Mexico: Piportil.
Drug combinations
Chemistry
Pipotiazine Palmitate: C~40~H~63~N~3~O~4~S~2~. Mw: 714.08. (1) Hexadecanoic acid, 2-[1-[3-[2-[(dimethylamino)sulfonyl]-10H-phenothiazin-10-yl]propyl]-4-piperidinyl]ethyl ester; (2) 10-[3-[4-(2-Hydroxyethyl)piperidino]propyl]-N,N-dimethylphenothiazine-2-sulfonamide palmitate (ester). CAS-37517-26-3; CAS-39860-99-6 (pipotiazine)(1973).
Pharmacologic Category
Antipsychotics; Phenothiazines. Piperidine. (ATC-Code: N05AC04).
Mechanism of action
Blocks postsynaptic mesolimbic dopaminergic receptors in brain. Depresses release of hypothalamic and hypophyseal hormones. Has relatively high propensity for causing extrapyramidal reactions.
Therapeutic use
Management of schizophrenia.
Pregnancy and lactiation implications
Safety and efficacy in pregnant women not established. Not recommended during lactation (unknown if excreted in breast milk).
Unlabeled use
Contraindications
Hypersensitivity to pipotiazine, phenothiazine derivatives, or any component of the formulation (cross-reactivity between phenothiazines may occur). Severe CNS depression. Subcortical brain damage. Hepatic or renal dysfunction. Circulatory collapse. Severe hypotension. Severely depressed patients. High doses of hypnotics. Bone marrow suppression. Blood dyscrasias. Coma. Pheochromocytoma.
Warnings and precautions
May alter cardiac conduction (life-threatening arrhythmias occurred with therapeutic doses of phenothiazines). Phenothiazines may cause anticholinergic effects (use with caution in decreased gastrointestinal motility, paralytic ileus, urinary retention, benign prostatic hypertrophy, xerostomia, or visual problems). Blood dyscrasias might occur (use contraindicated in bone marrow suppression). 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. May be associated with neuroleptic malignant syndrome (risk may be increased in Parkinson’s disease or Lewy body dementia). May cause orthostatic hypotension (use with caution in cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). Prolonged therapy may cause pigmentary retinopathy, corneal deposits, and/or changes in skin pigmentation. May cause sedation. Impaired core body temperature regulation may occur. Use with caution in severe cardiovascular disease, narrow-angle glaucoma (may be exacerbated by cholinergic blockade), myasthenia gravis (may be exacerbated by cholinergic blockade), Parkinson’s disease (patients may be more sensitive to adverse effects), breast cancer or other prolactin-dependent tumors (elevates prolactin levels), and in respiratory disease. Use with caution 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. Effects may be potentiated when used with other sedative drugs or ethanol. Use with caution in the elderly (increased risk for developing tardive dyskinesia). Adverse effects of depot injections may be prolonged. Some products may contain sesame oil (use with caution in known allergy to sesame oil or similar compounds).