fluphenazine decanoate

General information

• Class: Long-acting injectable antipsychotic
• Common US brands: PROLIXIN DECANOATE
• Typical dose range: Confirm oral tolerability and response before depot conversion when feasible. Conversion is individualized and should follow labeling and local protocols.
• Long-acting injectable formulation available.
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2025-12-30

Dosing & forms

• Forms/strengths: Long-acting depot injection: deep intramuscular injection, typically administered every 2–4 weeks (interval depends on dose and response).
• Typical range: Confirm oral tolerability and response before depot conversion when feasible. Conversion is individualized and should follow labeling and local protocols.

Mechanism (brief)

Long-acting injectable formulation of fluphenazine (high-potency phenothiazine D2 antagonist) used for schizophrenia maintenance when depot dosing supports adherence.

Metabolism & Half‑life

• Metabolism: CYP2D6
• Half‑life: —

Therapeutic Drug Monitoring (TDM)

Recommended: No

Long‑acting injectable (LAI)

Monitoring highlights

• Movement disorder monitoring (akathisia, parkinsonism, tardive dyskinesia) including periodic AIMS-style exams.
• ECG/QTc monitoring when clinically indicated (cardiac disease, electrolyte disturbances, QT-prolonging co-medications).
• Prolactin-related symptom review (sexual dysfunction, menstrual changes, galactorrhea).
• Injection site assessment and documentation (site rotation, local reactions).

Sources

• Fluphenazine decanoate prescribing information — DailyMed (2024)
• The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia — American Psychiatric Association (2020)
• Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis — The Lancet (2013)
• AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsycharmacology — Pharmacopsychiatry (2018)
• Triple advantages of injectable long acting second generation antipsychotics: relapse prevention, neuroprotection, and lower mortality — Schizophrenia Research (2018)