Health Centres - Stelazine (trifluoperazine)
How does it work?
Stelazine tablets and syrup contain the active ingredient trifluoperazine, which is a type of medicine called a phenothiazine antipsychotic. (NB. Trifluoperazine is also available without a brand name, ie as the generic medicine.) Trifluoperazine has two quite different uses. In higher doses it is used in the treatment of psychiatric illnesses. In lower doses it is used in the management of nausea and vomiting.
When used in psychiatric illness, trifluoperazine is sometimes described as a neuroleptic or a 'major tranquilliser', though this last term is fairly misleading, as this type of medicine is not just a tranquilliser, and any tranquillising effect is not as important as its main mechanism of action in psychiatric illness.
Trifluoperazine works by blocking dopamine receptors in the brain. Dopamine is a natural compound called a neurotransmitter, and is involved in transmitting messages between brain cells. Dopamine is a neurotransmitter known to be involved in regulating mood and behaviour, amongst other things.
Psychotic illness, and particularly schizophrenia, is thought to be caused by overactivity of dopamine in the brain. Trifluoperazine blocks the receptors that dopamine acts on, and this prevents the overactivity of dopamine in the brain. This helps to control psychotic illness.
Trifluoperazine is used used in the long-term management of psychotic conditions such as schizophrenia. It is also used in the short-term to manage severe anxiety and severely agitated or dangerous behaviour.
Trifluoperazine also affects dopamine receptors in an area of the brain that controls nausea and vomiting. Vomiting is controlled by an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness (nausea) and for the vomiting reflex. It is activated when it receives nerve messages from another area of the brain called the chemoreceptor trigger zone (CTZ) and when it receives nerve messages from the gut.
Trifluoperazine controls nausea and vomiting by blocking dopamine receptors found in the CTZ. This stops the CTZ from sending the messages to the vomiting centre that would otherwise cause nausea and vomiting.
Stelazine spansules are a 'controlled release' form of trifluoperazine. They are designed to release the trifluoperazine slowly and continuously over several hours. This produces a steady blood level of the medicine throughout the day. The spansules are designed to be taken once a day. They must be swallowed with water and not chewed or crushed, as this would damage the controlled release action.
What is it used for?
- Psychotic illness such as schizophrenia.
- Short-term treatment of severe anxiety.
- Short-term treatment of severely agitated behaviour and violent or dangerously impulsive behaviour.
- Nausea and vomiting.
Warning!
- This medicine may cause drowsiness. If affected do not drive or operate machinery. Alcohol should be avoided because it can make drowsiness worse.
- This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass.
- High doses of this medicine may make your skin more sensitive to sunlight than it usually is, so you should avoid exposing your skin to direct sunlight or sunlamps until you know how your skin reacts. If you can't avoid strong sunlight you should use a sunscreen lotion or make sure your skin is protected with clothing.
- If you have been taking high doses of this medicine for a long time, for example to treat schizophrenia, you should not suddenly stop taking it unless your doctor tells you to, even if you feel better and think you don't need it any more. This is because the medicine controls the symptoms of the illness but doesn't actually cure it. This means that if you suddenly stop treatment your symptoms could come back. Stopping the medicine suddenly may also rarely cause withdrawal symptoms such as nausea, vomiting, difficulty sleeping or tremor. When treatment with this medicine is stopped, it should be done gradually, following the instructions given by your doctor.
- This medicine may rarely cause a decrease in the normal amounts of white blood cells in the blood. For this reason, if you are taking high doses of this medicine for a long time your doctor may want you to have regular blood tests to check the levels of blood cells in your blood. You should consult your doctor immediately if you experience any of the following symptoms while taking this medicine, as they may indicate a problem with your blood cells: unexplained sore throat, mouth ulcers, infections, high temperature (fever) or general illness.
- Consult your doctor immediately if you experience abnormal movements, particularly of the face, lips, jaw and tongue, while taking this medicine. These symptoms may be indicative of a rare side effect known as tardive dyskinesia, and your doctor may ask you to stop taking this medicine, or decrease your dose.
- Consult your doctor immediately if you experience the following symptoms while taking this medicine: high temperature (fever), pale complexion, sweating, muscle stiffness, fast heartbeat and decreased consciousness. These symptoms may be due to a rare but serious side effect of this type of medicine, known as the neuroleptic malignant syndrome, and your treatment may need to be stopped.
Use with caution in
- Elderly people.
- Decreased kidney function.
- Heart disease.
-
Angina pectoris.
- Irregular heart beats (arrhythmias).
-
Epilepsy.
-
Abnormal muscle weakness .
-
Parkinson's disease.
-
Closed angle glaucoma.
-
Enlarged prostate gland .
- People who have experienced jaundice or problems with their blood cells during previous treatment with a phenothiazine medicine.
Not to be used in
- Allergy to other phenothiazine medicines, such as chlorpromazine or prochlorperazine.
- Disturbance in the normal numbers of blood cells in the blood.
-
Heart failure.
- Liver disease.
- Unresponsive unconscious states (comatose states).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine during pregnancy has not been established. It should not be used in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
- This medicine may pass into breast milk and could possibly have harmful effects on a nursing infant. You should seek medical advice from your doctor before breastfeeding while taking this medicine.
Label warnings
- This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.
- Stelazine spansules should be swallowed whole and not broken, crushed or chewed.
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