MESORIDAZINE BESYLATE
(mez-oh-rid'a-zeen)
Serentil
Classifications: central nervous system agent; psychotherapeutic; phenothiazine; antipsychotic
Prototype: Chlorpromazine
Pregnancy Category: C
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10 mg, 25 mg, 50 mg, 100 mg tablets; 25 mg/mL oral solution; 25 mg/mL injection
Piperidine derivative of phenothiazine. Tranquilizer with stronger sedative action than produced by chlorpromazine, but has
more antiemetic action and lower incidence of extrapyramidal adverse effects.
Antipsychotic effect due to psychomotor slowing and reduction of emotional stress.
Second-line therapy for schizophrenia, behavioral problems in mental deficiency and chronic brain syndrome, acute and chronic
alcoholism. Also to reduce symptoms of anxiety and tension associated with many neurotic disorders.
Known sensitivity to other phenothiazines; severely depressed (drug-induced) patient; comatose state; children <12 y. Safety
during pregnancy (category C) or lactation is not established.
Previously detected cancer of breast; glaucoma; prostatic hypertrophy, urinary retention; history of cardiovascular disease
(can prolong QTc interval).
Psychotic Disorders
Adult: PO 10–50 mg b.i.d. or t.i.d., may increase as needed up to 400 mg/d IM 25 mg, may repeat in 30–60 min if necessary
Dementia Behavior
Geriatric: PO 10 mg 1–2 times/d, may gradually increase q4–7d (max: 250 mg/d)
Management of Hyperactivity
Adult: PO 25 mg t.i.d. up to 75–300 mg/d
Alcohol Dependence
Adult: PO 25 mg b.i.d. up to 50–200 mg/d
Anxiety & Tension
Adult: PO 10 mg b.i.d. up to 150 mg/d
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Oral
- Measure drug with calibrated dispenser included in original package. Dilute oral concentrate in about ½ glass (120 mL) of
fluid just before administration. Use fruit juices, water, soup, carbonated beverage.
Intramuscular
- Inject IM solution slowly and deeply into upper outer quadrant of buttock. Advise patient to lie still for 20–30 min
after the injection to minimize possible dizziness.
- Slight yellowing of the solution will not change potency; however, darkened solution should be discarded.
- Store at 15°–30° C (59°–86° F); refrigeration is not necessary. Protect solution from light
and freezing.
CNS: Dizziness, sedation, fainting, extrapyramidal effects, dystonic reactions, akathisia, tardive dyskinesia, neuroleptic malignant syndrome. Special Senses: Blurred vision, xerostomia, nasal congestion. Urogenital: Urinary retention or incontinence, ejaculation dysfunction, impotence, priapism. GI: Constipation. Body as a Whole: Decreased sweating. Skin: Rash, exfoliative dermatitis photosensitivity. CV: Tachycardia, orthostatic hypotension, arrhythmias (prolong QTc interval) heart block.
Drug:
Amiodarone,
amoxapine,
bepridil,
clarithromycin,
daunorubicin,
diltiazem,
disopyramide,
dofetilide,
dolasetron,
doxorubicin,
encainide,
erythromycin,
flecainide,
gatifloxacin,
grepafloxacin,
haloperidol,
ibutilide,
indapamide,
local anesthetics, maprotiline,
moxifloxacin,
octreotide,
pentamidine,
pimozide,
procainamide,
probucol,
quinidine,
risperidone,
sotalol,
sparfloxacin,
tocainide,
tricyclic antidepressants, verapamil, and ziprasidone prolong the QTc interval and can cause arrhythmias; amantadine,
clozapine,
cyclobenzaprine,
diphenoxylate,
olanzapine,
orphenadrine,
sedating h1-blockers may have additive anticholinergic effects; entacapone,
tolcapone,
pramipexole,
ropinirole
anticonvulsants may cause additive drowsiness and CNS depressant effects. Herbal:
Kava-kava may increase risk and severity of dystonic reactions.
Absorption: Readily absorbed from GI tract. Peak: 2 h PO; 30 min IM. Duration: 4–6 h PO; 6–8 h IM. Metabolism: Metabolized in liver. Elimination: Excreted in urine and bile. Half-Life: 24–48 h.
Assessment & Drug Effects
- Monitor I&O and bowel elimination patterns and check bladder for distension. Depressed patients often fail to report urinary
discomfort or constipation.
- Report to physician if patient complains of blurred vision. Periodic ophthalmic examinations are advisable with long-term
therapy.
- Monitor BP with patient supine and standing.
Patient & Family Education
- Avoid spilling drug on skin since it may cause contact dermatitis. Thoroughly rinse off with water if spilling occurs.
- Do not drive or engage in potentially hazardous activities until response to drug is known. Dizziness and drowsiness are possible
during early period of therapy.
- Expect drowsiness to decrease with continued therapy. If it persists consult physician. A change in time of administration
or dose may help to prevent interference with normal physical activities.
- Dangle legs at bedside when rising because of possible orthostatic hypotension.
- Avoid alcohol during therapy.
- Relieve dry mouth by rinsing frequently with water, sucking hard candy.
- Do not breast feed while taking this drug without consulting physician.
1%)
Canadian drug name; 
Prototype drug