Fluphenazine

Drug Levels and Effects:




Summary of Use during Lactation:


There is no published experience with fluphenazine during breastfeeding. Very limited long-term follow-up data indicate no adverse developmental effects when other phenothiazines are used alone. However, combinations of antipsychotic agents can negatively affect development. Because of the lack of published experience with fluphenazine during breastfeeding, other antipsychotic agents may be preferred, especially wile nursing an newborn or preterm infant.


Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


Phenothiazines cause galactorrhea in 26 to 40% of female patients.[1][2] Hyperprolactinemia appears to be the cause of the galactorrhea.[3][4][5] The hyperprolactinemia is caused by the drug's dopamine-blocking action in the tuberoinfundibular pathway.[6]

Fluphenazine elevates serum prolactin similar to other phenothiazines and has caused galactorrhea. The elevation is related to serum levels and lasts 2 to 4 weeks with the depot injectable formulation.[2][7] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.


Alternate Drugs to Consider:


Haloperidol,Risperidone


References:


1. Polishuk WZ, Kulcsar S. Effects of chlorpromazine on pituitary function. J Clin Endocrinol Metab. 1956;16:292-3. PMID:13286329
2. Hooper JH Jr, Welch VC, Shackelford RT. Abnormal lactation associated with tranquilizing drug therapy. JAMA. 1961;178:506-7. PMID:14448766
3. Turkington RW. Prolactin secretion in patients treated with various drugs: phenothiazines, tricyclic antidepressants, reserpine, and methyldopa. Arch Intern Med. 1972;130(3):349-54. PMID:4560178
4. Turkington RW. Serum prolactin levels in patients with gynecomastia. J Clin Endocrinol Metab. 1972;34(1):62-6. PMID:5061776
5. Meltzer HY, Fang VS. The effect of neuroleptics on serum prolactin in schizophrenic patients. Arch Gen Psychiatry. 1976;33:279-86. PMID:1259521
6. Maguire GA. Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences. J Clin Psychiatry. 2002;63(suppl 4):56-62. PMID:11913677
7. Meltzer HY, Fang VS, Goode DJ. Prolactin and neuroleptics: clinical implications for efficacy and toxicity. The effect of neuroleptics and alpha-methyl-para-tyrosine on serum prolactin levels in laboratory animals and man. Psychopharmacol Bull. 1978;14:5-7. PMID:625539



Substance Identification:




Substance Name:

Fluphenazine

CAS Registry Number:

69-23-8

Drug Class:


  • Antipsychotic Agents

  • Phenothiazines


  • Administrative Information:




    LactMed Record Number:


    116


    Last Revision Date:


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