In connection with the possible cross-sensitivity, caution should be given to the Moditen® Depot preparation in patients with allergic reactions to phenothiazine derivatives in the anamnesis.
With the development of cholestatic jaundice as an adverse reaction, treatment with Moditen® Depot should be discontinued.
When performing surgical operations, patients who take high doses of phenothiazine derivatives may experience a sharp decrease in blood pressure.
It may be necessary to reduce the doses of anesthetics or antipsychotics in some patients when treated with the Moditene® Depot; Potentiation of the effect of m-holinoblockers is possible, since fluphenazine has m-anticholinergic action.
Caution is advised to prescribe the Moditen® Depot in very hot weather or poisoning with phosphoric insecticides, patients with seizures in the anamnesis (as cases of large epileptic seizures are described in the course of treatment with fluphenazine), as well as patients with mitral valve insufficiency or other cardiovascular disorders, vascular system or with pheochromocytoma.
It is necessary to prescribe with caution the drug for breast cancer, tk. as a result of derivatives induced phenothiazine prolactin secretion increases the risk of disease progression and resistance to treatment with endocrine and cytotoxic drugs.
Cases of development, venous thromboembolism were noted with the use of antipsychotic medications. Since patients who take antipsychotic medications often have risk factors for venous thromboembolism, it is necessary to assess these factors before and during treatment and take appropriate preventive measures.
When prescribing to patients with Parkinson's disease, extrapyramidal effects may increase.
Emerging as side effects, extrapyramidal symptoms are usually reversible, but can be persistent. The likelihood and severity of such unwanted adverse reactions depends more on individual sensitivity than on other factors, but the magnitude of the dose and age of the patient are important. The patient should be warned in advance about such manifestations and their reversibility.Usually, to eliminate these undesirable phenomena, it is sufficient to prescribe m-holinoblokatorov or antiparkinsonic drugs and / or reduce the dose of the drug.
Late dyskinesia
The severity of this syndrome and the resulting worsening of the condition can vary considerably in different patients. Late dyskinesia is manifested either during treatment, with a lower dose, or after discontinuation of therapy. Early detection of tardive dyskinesia is very important. For the detection of this syndrome, the initial stage is recommended / periodic dose reduction, neuroleptic (if possible on the condition of the patient) and patient monitoring during this period. This approach is extremely important; because treatment with antipsychotics can mask the manifestations of tardive dyskinesia.
Malignant neuroleptic syndrome
With the development of this adverse reaction should immediately stop taking neuroleptics and other medications that do not affect the maintenance of vital functions, as well as intensive symptomatic treatment, continuous monitoring of vital functions, and therapy of concomitant diseases.
Disorders of cerebral circulation
Approximately 3-fold increase in the risk of developing cerebrovascular disorders was observed with the administration of some atypical neuroleptics in patients with dementia in the anamnesis. There was an increase in the mortality of elderly patients with a history of dementia during antipsychotic medications. The degree of risk and the causes of this phenomenon are unknown.
The cause of this phenomenon is unknown, however, the increased risk of developing cerebral circulation disorders in other populations of patients or with the administration of other neuroleptics can not be ruled out. In this regard, care must be taken when taking Moditen® Depot with patients at risk of developing cerebrovascular accident.
Hypotension against treatment with fluphenazine is rare. At the same time, in patients with pheochromocytoma, cerebrovascular, renal and severe heart failure (for example, in patients with mitral valve insufficiency), hypotension with Moditen® Depot is more frequent; careful monitoring is necessary for these patients. With the development of severe hypotension, rapid intravenous administration of vasoconstrictive drugs is necessary.Is best suited for that norepinephrine for injections. Epinephrine It should not be used because phenothiazine derivatives distort the reaction to epinephrine, resulting in an even greater reduction in blood pressure.
With the development of diseases of the mucous membrane of the mouth, gums or throat or. infection of the upper respiratory tract in combination. with a change in the number of leukocytes confirming the inhibition of hematopoiesis, therapy with Moditen® Depot should be canceled, and the necessary medical measures are immediately started.
Patients with seizures in the anamnesis should be cautious appoint phenothiazine derivatives, including the drug Moditen® Depot.
It should be taken into account that the antiemetic effect of phenothiazine derivatives (including Moditen® Depot) can mask vomiting associated with overdose of other drugs.
Abrupt withdrawal of the drug: mainly the reception of phenothiazine derivatives. does not cause psychic dependence, however, cases of gastritis, nausea and vomiting, and dizziness with a sharp abolition of high doses of phenothiazine were noted.These symptoms decreased with subsequent withdrawal after taking antiparkinsonian drugs for several weeks.
The drug contains sesame oil, which in rare cases can cause severe allergic reactions.
Gasoline alcohol contained in the product can cause severe toxic and anaphylactoid reactions in children older than 12 years.
The intake of alcohol during the treatment of drugs is prohibited.
Do not store medication in the refrigerator, as it will lead to the deposition of triglycerides belonging to the sesame oil. When the sludge drug should be heated to 37 ° C, the precipitate was dissolved without loss of activity of the active substance.