Flupentixol Long-Acting Injection: Complete Guide For Patients
Complete guide to flupentixol depot injections for schizophrenia and depression treatment.
Understanding Flupentixol Long-Acting Injection
Flupentixol is an antipsychotic medication prescribed to treat two different conditions: schizophrenia (marketed as Depixol) and depression (marketed as Fluanxol). The long-acting or ‘depot’ injection formulation is used once your symptoms have been adequately controlled by taking tablets. This treatment approach represents a significant advancement in mental health management, offering improved convenience and consistency in medication delivery compared to daily oral medications.
The long-acting depot injection slowly releases flupentixol into your body over an extended period. The main advantage of this depot injection format is that you do not have to remember to take tablets every day, which can improve medication adherence and reduce the risk of symptom relapse. For patients struggling with daily medication routines, this can be transformative in managing their condition.
What is Flupentixol and How Does It Work
Flupentixol is an antipsychotic agent with anxiolytic and mild sedative actions. It exerts weak anticholinergic and adrenergic effects, making it suitable for managing various psychiatric symptoms. The exact mechanism of action of flupentixol has not been fully established, but its effects resemble those of other antipsychotic medications used in psychiatric treatment.
When administered as a long-acting injection, esterified flupentixol diffuses slowly from the oil solution and is gradually released into the extracellular fluid and circulation, distributing to different tissues throughout the body. Peak drug concentrations are reached between four and seven days following intramuscular injection. The medication remains detectable in the blood three weeks after injection and reaches steady-state concentrations after about three months of repeated administration.
How Flupentixol Long-Acting Injection is Administered
Before starting treatment, ask to read the manufacturer’s printed information leaflet from inside the pack. The leaflet provides comprehensive information about flupentixol and a full list of potential side-effects you could experience.
Flupentixol long-acting injection is administered by a doctor or nurse into a muscle in your buttocks or upper leg. If you haven’t received an injection like flupentixol before, a small test dose is usually given one week before you receive a full dose. This test injection helps your healthcare team assess how well you tolerate the medication.
The injection schedule is as follows:
- Injections are given every 2-4 weeks
- If you miss an appointment, make another appointment as soon as possible
- You may be asked to continue taking your tablets for a short while after your first injection
- This is because it can take a few weeks before you feel the full effect from the injection
A single injection usually lasts between 2-3 weeks, though this can vary depending on the dose and individual response. The medicine is slowly released from the injection site so that a fairly constant amount gets into your blood during the period between each dose.
Dosing Information
The dosage of flupentixol is highly individualized and depends on your specific condition, response to treatment, and other factors. For adults with schizophrenia, the usual dose lies between 50 mg every 4 weeks to 300 mg every 2 weeks, though some patients require 400 mg every week. The maximum single dose at any one time is 400 mg.
A second dose of 20 to 40 mg is usually given 4-10 days after the first injection, with further doses given every 2 to 4 weeks for the majority of patients. Dosage adjustments are made in accordance with your response to treatment. The optimal amount of the drug varies with the clinical circumstances and your individual response.
For older patients above 65 years, starting doses are usually reduced to a quarter or a half of the dosage range. Depixol Injection is not recommended for children.
Important Considerations Before Treatment
Before you start having flupentixol long-acting injections, it is important that your doctor knows about your medical history. Tell your doctor if any of the following apply to you:
- If you are pregnant or breastfeeding
- If you have a heart condition or blood vessel disease
- If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work
- If you have prostate problems
- If you have any problems with your breathing
- If you have epilepsy, diabetes, depression, Parkinson’s disease, raised pressure in your eye (glaucoma), thyroid problems, or myasthenia gravis
- If you have ever had yellowing of your skin or the whites of your eyes (jaundice)
- If you have a blood disorder, particularly porphyria
- If you have a tumor on your adrenal gland (phaeochromocytoma)
- If you have had an allergic reaction to a medicine
- If you are taking or using any other medicines, including over-the-counter medications and herbal remedies
Treatment with flupentixol is usually long-term to prevent your symptoms from returning. Your doctor will discuss the expected duration of treatment and monitor your progress regularly.
Special Precautions and Monitoring
If you have diabetes, you may need to check your blood sugar (glucose) more frequently, as flupentixol can affect the levels of sugar in your blood. Your doctor will advise you about this and may recommend more frequent monitoring.
If you are having any dental treatment or an operation, tell the person carrying out the treatment that you have had a flupentixol injection. This is important because the medication may interfere with the anesthetic you receive. If you undergo surgery, special care should be taken, as patients on large doses of flupentixol decanoate should be watched carefully for possible low blood pressure phenomena, and anesthetic or central nervous system depressant drug dosages may have to be reduced.
If you buy or take any ‘over-the-counter’ medicines, check with a pharmacist that they are suitable for you to take with flupentixol.
Common Side Effects and How to Manage Them
A number of side-effects could be experienced from the treatment. If you are concerned about any, you should discuss them with your doctor. Here is a table of common side effects and suggested management strategies:
| Side Effect | Management Strategy |
|---|---|
| Feeling sleepy | Do not drive and do not use tools or machines while affected |
| Feeling restless, movement problems | Speak with your doctor |
| Dry mouth | Try chewing sugar-free gum or sucking sugar-free sweets |
| Pain at the site of the injection | This should not last long. If the area becomes red, swollen or ‘lumpy’, let your doctor know |
| Feeling dizzy or tired, blurred vision | Do not drive and do not use tools or machines while affected |
| Headache | Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If headaches continue, speak with your doctor |
| Unusual or uncontrollable muscle movements, feeling shaky | Speak with your doctor about these |
If you experience any other symptoms which you think may be due to the injection, speak with your doctor or pharmacist for further advice.
Serious Side Effects and When to Seek Immediate Help
If you experience symptoms such as muscle stiffness, a very high temperature, feeling confused or sweaty, a fast heartbeat, and urinary incontinence, you should contact your doctor immediately. These can be signs of a rare but serious condition known as neuroleptic malignant syndrome. This condition requires urgent medical attention and is a medical emergency.
In view of the potential for adverse effects, flupentixol injection should be prescribed in a manner that is most likely to minimize the risk of tardive dyskinesia, a condition involving involuntary movements. As with any antipsychotic drug, flupentixol should be administered at the smallest dose and for the shortest duration necessary to achieve therapeutic benefit.
Long-Term Treatment Considerations
Treatment with flupentixol is usually long-term so that your symptoms don’t return. The long-acting depot formulation is particularly useful for maintenance treatment of patients with chronic schizophrenia and other psychiatric conditions. However, there is considerable variation in the individual response of patients to flupentixol decanoate, and its use for maintenance therapy requires careful supervision by healthcare professionals.
Your doctor may decide to adjust the amount given or the interval between injections from time to time, depending on how well the treatment is working for you and whether you experience any side effects. If you have liver problems, the level of flupentixol in your blood may be checked.
To lessen the likelihood of adverse reactions related to drug accumulation, careful monitoring is essential for patients on long-term flupentixol therapy. In the subsequent five to ten days after an initial injection, the therapeutic response and the appearance of extrapyramidal symptoms should be carefully monitored, with oral neuroleptic drugs potentially continued in diminishing dosage during this period.
Frequently Asked Questions (FAQs)
Q: How often will I need to receive flupentixol injections?
A: Flupentixol long-acting injections are typically given every 2-4 weeks. The exact interval depends on your dose and individual response to treatment, which your doctor will determine.
Q: What happens if I miss an appointment for my injection?
A: If you miss an appointment, make another appointment as soon as possible. It is important to maintain your injection schedule to ensure consistent symptom control and prevent relapse.
Q: Can I stop taking my tablets when I start the injections?
A: You may be asked to continue taking your tablets for a short while after your first injection because it can take a few weeks before you feel the full effect from the injection. Your doctor will advise you when it is safe to stop the tablets.
Q: Is flupentixol suitable for children?
A: Depixol Injection is not recommended for children. Treatment is typically for adults, with adjusted starting doses for older patients above 65 years.
Q: What should I do if I experience severe side effects?
A: If you experience symptoms such as muscle stiffness, very high temperature, confusion, sweating, fast heartbeat, or urinary incontinence, contact your doctor immediately, as these may indicate a serious condition called neuroleptic malignant syndrome.
Q: Can flupentixol affect my blood sugar levels?
A: Yes, flupentixol can affect blood sugar levels. If you have diabetes, you may need to check your blood sugar more frequently, and your doctor will advise you about appropriate monitoring.
Q: Is it safe to drive after receiving a flupentixol injection?
A: Some people experience sleepiness, dizziness, or blurred vision as side effects. If you experience these symptoms, do not drive and do not use tools or machines while affected. Always wait until these effects have worn off before driving.
References
- Flupentixol long-acting injection – Patient.info — Patient.info. Accessed 2025. https://patient.info/medicine/flupentixol-long-acting-injection-depixol-psytixol
- Flupentixol Decanoate Injection BP – Product Monograph — Health Canada. https://pdf.hres.ca/dpd_pm/00013762.PDF
- Flupentixol: Uses, Interactions, Mechanism of Action — DrugBank. https://go.drugbank.com/drugs/DB00875
- Depixol® 20 mg/ml solution for injection – Patient Information Leaflet — Medicines.org.uk. https://www.medicines.org.uk/emc/files/pil.995.pdf
- Flupenthixol decanoate Clinical Information — CHEO ED Outreach. https://outreach.cheo.on.ca/manual/1580
- Fluanxol Depot – Patient Information — Lundbeck. https://www.lundbeck.com/content/dam/lundbeck-com/americas/canada/products/files/fluanxol_patient_information_english.pdf
- Fluanxol® Depot 20 mg/mL Medication Information — NPS MedicineWise. https://www.nps.org.au/assets/medicines/411f5597-5bdb-4a01-b1ed-a53300ff29f4.pdf
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