MOLINDONE HYDROCHLORIDE
(moe-lin'done)
Moban
Classifications: central nervous system agent; psychotherapeutic; antipsychotic phenothiazine
Prototype: Chlorpromazine
Pregnancy Category: C

Availability

5 mg, 10 mg, 25 mg, 50 mg, 100 mg tablets; 20 mg/mL liquid

Actions

Tranquilizer structurally unrelated but pharmacologically similar to the piperazine phenothiazines; thought to block postsynaptic dopamine receptors in the brain. Has less sedative but comparable anticholinergic activity and greater incidence of extrapyramidal adverse effects than chlorpromazine. EEG studies suggest ascending reticular system is chief site of action.

Therapeutic Effects

Reportedly lowers convulsive threshold and produces tranquilization without compromising alertness. Antipsychotic effect includes reduction in bizarre behavior, and control of aggressiveness.

Uses

Management of manifestations of psychotic disorders.

Contraindications

Known hypersensitivity to molindone or to phenothiazines; severe CNS depression; comatose states; children <12 y. Safety during pregnancy (category C) or lactation is not established.

Cautious Use

Those harmed by increase in physical activity; prostatic hypertrophy; cardiovascular disease; previously detected cancer of breast.

Route & Dosage

Psychotic Disorders
Adult: PO 50–75 mg/d in 3–4 divided doses, may be increased to 100 mg/d in 3–4 d or may be able to decrease to 15–60 mg/d in divided doses (max: 225 mg/d)

Administration

Oral

Adverse Effects (1%)

CNS: Transient drowsiness, insomnia, extrapyramidal symptoms (dose related), euphoria, neuroleptic malignant syndrome. GI: Dry mouth, constipation, hepatotoxicity. Special Senses: Tinnitus, blurred vision, nasal congestion. Urogenital: Urinary retention. Skin: Mild photosensitivity. CV: Tachycardia. Body as a Whole: Change in weight. Endocrine: SLE-like syndrome, heavy menses, amenorrhea, galactorrhea, gynecomastia, increased libido, premature ejaculation.

Interactions

Drug: May potentiate CNS depression with cns depressants, alcohol. Herbal: Kava-kava may increase risk and severity of dystonic reactions.

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Peak: 1 h. Duration: 24–36 h. Distribution: Distributed into breast milk. Metabolism: Metabolized in liver. Elimination: Excreted in urine and feces. Half-Life: 1.5 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug