Introduction
Opsonil 50 is a medicine used to treat various disorders such as schizophrenia and other psychoses like paranoia (delusions and feeling extremely worried or nervous), mania (overactive behavior), anxiety, agitation, and dangerously impulsive behavior. Opsonil 50 is also used for controlling intractable hiccups, feeling or being sick (nausea), and autism (learning and communication difficulties). This medicine belongs to a group of drugs known as phenothiazines, which act on the central nervous system. It alters the thoughts and elevates the mood, improving the person's ability to think, feel and behave. Opsonil 50 may be taken with or without 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. This medicine can lead to weight gain, have a healthy balanced diet and exercise regularly. Before taking this medicine, inform your doctor if you have any liver disease, thyroid or kidney disease, epilepsy, Parkinson's disease, or any heart disease. If you are diabetic, it is important to monitor your blood glucose regularly while taking this medicine.
Side effects of Opsonil 50
Common
- Sleepiness
- Orthostatic hypotension (sudden lowering of blood pressure on standing)
- Dryness in mouth
- Abnormality of voluntary movements
- Weight gain
- Increased prolactin level in blood
- Urinary retention
- Constipation
- Muscle stiffness
How to use Opsonil 50
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. Opsonil 50 may be taken with or without food, but it is better to take it at a fixed time.
How Opsonil 50 works
Opsonil 50 is a typical antipsychotic. It works by blocking the action of dopamine, a chemical messenger in the brain that affects thoughts and mood.
Indication
Schizophrenia, Bipolar disorder, Anxiety, Psychoses, Delirium, Porphyria, Hiccups, Nausea, Vomiting
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort. Direct IV injection is only for control of nausea and vomiting during surgery and for adjunctive treatment of tetanus IV infusion is only for adjunctive treatment of intractable hiccups in adults IV Administration Direct IV injection: Dilute with NS to concentration no higher than 1 mg/mL, and administer at rate of 1 mg/min in adults and 0.5 mg/min in children; avoid administering undiluted drug IV infusion: Add appropriate dose to 500-1000 mL of NS, and administer slowly
Adult Dose
Schizophrenia, Psychotic Disorders PO: 30-75 mg/day divided q6-12hr initially; maintenance: usually 200 mg/day (up to 800 mg/day in some patients; some patients may require 1-2 g/day) IV/IM: 25 mg initially, followed PRN with 25-50 mg after 1-4 hours, then increased to maximum of 400 mg q4-6hr until patient is controlled; usual dosage 300-800 mg/day Nausea & Vomiting PO: 10-25 mg q4-6hr PRN IV/IM: 25-50 mg q4-6hr PRN Preoperative Apprehension 25-50 mg PO 2-3 hours before surgery 12.5-25 mg IM 1-2 hours before surgery Intraoperative Sedation 12.5 IM q30min or 2 mg IV q2min; total dose not to exceed 25 mg Intractable Hiccups 25-50 mg PO q6-8hr; if hiccups persist after 2-3 days of oral therapy, administer 25-50 mg IM q3-4hr; if symptoms persist, administer 25-50 mg by slow IV infusion with patient lying flat in bed; monitor BP Acute Intermittent Porphyria 25-50 mg PO q6-8hr Elderly: Initially, 1/3-½ the normal adult dose.
Child Dose
Behavioral Disorders, Hyperactivity >6 months: 50-100 mg/day PO/IM; 200 mg/day or more may be necessary for older hospitalized patients; for outpatients, may administer 0.55 mg/kg q4-6hr PRN Nausea & Vomiting >6 months: 0.5-1 mg/kg PO/IM q6-8hr PRN Preoperative Apprehension >6 months: 0.55 mg/kg PO/IM 1-2 hours before surgery <6 months: Safety and efficacy not established
Contraindication
Do not use in patients with known hypersensitivity to phenothiazines. Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).
Mode of Action
Chlorpromazine is a neuroleptic that acts by blocking the postsynaptic dopamine receptor in the mesolimbic dopaminergic system and inhibits the release of hypothalamic and hypophyseal hormones. It has antiemetic, serotonin-blocking, and weak antihistaminic properties and slight ganglion-blocking activity.
Precaution
Some patients exposed chronically to antipsychotics will develop tardive dyskinesia, Chlorpromazine should be administered cautiously to persons with cardiovascular, liver or renal disease. There is evidence that patients with a history of hepatic encephalopathy due to cirrhosis have increased sensitivity to the CNS effects of chlorpromazine (i.e., impaired cerebration and abnormal slowing of the EEG). Because of its CNS depressant effect, chlorpromazine should be used with caution in patients with chronic respiratory disorders such as severe asthma, emphysema and acute respiratory infections, particularly in children (1 to 12 years of age). Because chlorpromazine can suppress the cough reflex, aspiration of vomitus is possible. Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics [AAP] states that this is "of concern")
Side Effect
Extrapyramidal symptoms. Tardive dyskinesia (on long-term therapy). Involuntary movements of extremities may also occur. Dry mouth, constipation, urinary retention, mydriasis, agitation, insomnia, depression and convulsions; postural hypotension, ECG changes. Allergic skin reaction, amenorrhoea, gynaecomastia, weight gain. Hyperglycaemia and raised serum cholesterol. Potentially Fatal: Agranulocytosis. Instantaneous deaths associated with ventricular tachyarrhythmias. Marked elevation of body temperature with heat stroke. Neuroleptic malignant syndrome, extrapyramidal dysfunction.
Pregnancy Category Note
Pregnancy category: C; neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others necessitating ICU support and prolonged hospitalization Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics [AAP] states that this is "of concern")
Interaction
Potentiation of anticholinergic effects of antiparkinson agents and TCAs may lead to an anticholinergic crisis. Additive orthostatic hypotensive effect in combination with MAOIs. Reverses antihypertensive effect of guanethidine, methyldopa and clonidine. Potentially Fatal: Additive depressant effect with sedatives, hypnotics, antihistamines, general anaesthetics, opiates and alcohol.