Introduction
Melleril is a prescription medicine used in the treatment of schizophrenia. It alters the thoughts and elevates the mood, improving the person’s ability to think, feel and behave.
Melleril should be taken with food, preferably at the same time each day. Take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember it. Do not skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms.
Some common side effects of this medicine include dry mouth, abnormality of voluntary movements, urinary retention, constipation, and muscle rigidity. Initially, this medicine may cause a sudden drop in blood pressure when you change positions, rise slowly if you have been sitting or lying down. It may also cause dizziness and sleepiness, do not drive or do anything that requires mental focus until you know how this medicine affects you.
Before taking it, inform your doctor if you are suffering from thyroid or kidney problems, epilepsy, Parkinson's disease, glaucoma, or any heart problems. You should not take this medicine if you are under the influence of alcohol or any sleep-inducing, cough, and/ or allergy medication. This medicine can also lead to weight gain, eat a healthy balanced diet, avoid snacking with high-calorie food, and exercise regularly.
Side effects of Melleril
Common
- Orthostatic hypotension (sudden lowering of blood pressure on standing)
- Sleepiness
- Dryness in mouth
- Abnormality of voluntary movements
- Weight gain
- Increased prolactin level in blood
- Urinary retention
- Constipation
- Muscle stiffness
- Tremor
How to use Melleril
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Melleril is to be taken with food.
How Melleril works
Melleril is a typical antipsychotic. It works by blocking the action of dopamine, a chemical messenger in the brain that affects thoughts and mood.
Indication
Depression, Schizophrenia
Administration
Should be taken with food.
Adult Dose
Oral
Schizophrenia
Adult: Initially, 50-100 mg tid, gradually increased if necessary in increments of not more than 100 mg wkly. Usual daily dose: 200-800 mg in 2-4 divided doses. Max: 800 mg daily.
Depressive Disorders
Adult: Initially, 25 mg tid, titrated to 20-200 mg daily.
Hepatic impairment: Lower initial doses and more gradual dosage increase.
Child Dose
Oral
Schizophrenia
Child: 2-12 yr: Initially, 0.5 mg/kg daily in divided doses, increased gradually until optimum effect obtained. Max: 3 mg/kg daily.
>12 years: Initial 50-100 mg PO q8hr; titrate to 200-800 mg/day PO divided q6-12hr
Renal Dose
Renal impairment: Lower initial doses and more gradual dosage increase.
Contraindication
Hypersensitivity to phenothiazines, comatose states, pre-exisitng CNS depression, severe CVS disorders, uncorrected hypokalaemia or any electrolyte imbalance, known or suspected QT prolongation, history of ventricular arrhythmias including torsades de pointes and porphyria. Bone-marrow suppression, phaeochromocytoma, or prolactin-dependent tumours, angle-closure glaucoma, history of jaundice, parkinsonism, DM, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia, or urinary retention. Patients with reduced activity of cytochrome P450 isoenzyme CYP2D6.
Mode of Action
Thioridazine, a phenothiazine antipsychotic, exhibits strong beta-adrenergic blocking effects and depresses the release of hypothalamic and hypophyseal hormones by blocking postsynaptic mesolimbic, dopaminergic receptors in the brain.
Precaution
Patient w/ severe CV disease, narrow-angle glaucoma, Parkinson's disease, seizure disorder. Avoid abrupt withdrawal. Hepatic and renal impairment. Elderly w/ dementia-related psychosis. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Determine ECG and serum K concentrations at baseline and periodically thereafter.
Side Effect
Tardive dyskinesia; leucopenia, neutropenia, agranulocytosis; drowsiness, pseudoparkinsonism and other extrapyramidal symptoms 60%;
Dry mouth, blurred vision, constipation, nausea, vomiting, diarrhoea, nasal stuffiness, pallor; galactorrhoea, breast engorgement, amenorrhoea, inhibition of ejaculation, peripheral oedema; dermatitis, skin eruptions. Rarely, nocturnal confusion, hyperactivity, lethargy, psychotic reactions, restlessness, headache, photosensitivity, parotid swelling.
Potentially Fatal: Prolongation of QTc interval resulting to torsades de pointes type arrhythmias and polymorphic ventricular tachycardia.
Interaction
Potentiates adverse effects of anticholinergics. Concurrent use of TCAs leads to raised blood levels of both drugs. May antagonise effects of levodopa, bromocriptine and other dopamine agonists. Avoid co-admin with drugs that cause electrolyte imbalance. Monitor phenytoin therapy due to inconsistent effects of thioridazine on phenytoin levels.
Potentially Fatal: Increased risk of QT prolongation with class IA and class II antiarrhythmics, astemizole, cisapride, pimozide, droperidol, erythromycin IV, sparfloxacin, terfenadine, clarithromycin and other drugs that may prolong QT interval. Potentiates CNS depression with opioids. Increased risk of arrhythmias with ephedrine-like drugs e.g. phenylpropanolamine. Increased thioridazone levels with fluovoxamine, pindolol, propranolol, ritonavir and other CYP2D6 isoenzymes inhibitors (e.g. fluoxetine, paroxetine).