Parenteral Manual

Flupenthixol decanoate (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Fluanxol Depot
Original Date: 
August 2005
  • Long-acting depot medication for the treatment of chronic psychosis
Reconstitution and Stability: 
  • Available in 2% and 10% solutions; solutions are a yellow viscous oil
  • Do not let drug stand in syringe for longer than 15 minutes

- No information


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IM YES, give deep into large muscle
IV Push NO
IV Intermittant Infusion NO
IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Initial Dose:

  • For patients not previously treated with a long-acting depot antipsychotic:
    - Initial test dose of 5 mg-20 mg of 2% Fluanxol depot®;
  • Previous treatment with a long-acting depot antipsychotic:
    - Initial test dose of 20-40 mg of 2% Fluanxol depot®;
  • A second dose of 20-40 mg of 2% Fluanxol depot® is given at least 4-10 days after the initial dose.

Maintenance Dose:

  • 20-100 mg every 2-4 weeks, adjusting to patient response.
Potential hazards of parenteral administration: 
  • Frequent extrapyramidal effects (akathisia, dystonias, dyskinesia, rigidity, tremor, etc), excitation.
  • Tardive dyskinesia (protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements); risk is greater in patients on higher doses.
  • Aspirate before injection to ensure that intravascular injection does not occur.
  • Use at least a 21 gauge needle, use Z track method, rotate sites, DO NOT massage injection site
  • Contraindicated in patients with a known hypersensitivity to thioxanthenes, in the presence of CNS depression due to any cause, comatose states, subcortical brain damage, blood dyscrasias, liver damage, cerebrovascular or renal insufficiency, pheochromocytoma and severe cardiovascular disorders.
  • Peak concentrations of the drug occur in 4-7 days.
  • A single injection usually lasts between 2-3 weeks.
  • Increase flupenthixol decanoate in increments of no more than 20 mg to decrease the incidence of extrapyrimidal reactions

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