📋 Indications & Clinical Dosage
*Schizophrenia:*
Adult: Initially 37 mg once daily, increased if necessary up to 148 mg once daily.
*Schizophrenia with concomitant moderate CYP3A4 inhibitors:*
Adult: Initially 18.5 mg once daily. Max. per dose 74 mg once daily.
⚠️ Precautions & Warnings
Moderate to severe renal impairment, moderate hepatic impairment, history of alcohol abuse or alcoholism, High doses in elderly. susceptibility to QT interval prolongation. Monitor BP and heart rate in hypertensive patients. Test liver function before treatment and then regularly thereafter especially when clinically indicated. Dose adjustment may be necessary if smoking started or stopped during treatment.
🔄 Drug Interactions
Strong CYP3A4 inhibitors (avoid), CYP3A4 inducer, alcohol, smoking, hepatotoxic drugs
⚠️ Adverse Reactions / Side Effects
Anxiety, angina, AV block, bradycardia, dysphagia, musculoskeletal stiffness, catatonia, decreased appetite, dysarthria, dysuria, hot flush, myalgia, nightmares, panic attacks, pruritus. Rare: Suicidal behavior, vertigo
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Avoid, use only if potential benefit outweighs risk
Lactation / Breastfeeding:
Contraindicated, discontinue breast feeding
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.