Appropriate dosage of Prolixin Decanoate (Fluphenazine Decanoate Injection) should be individualized for each patient and responses carefully monitored. No precise formula can be given to convert to use of Prolixin Decanoate; however, a controlled multicentered study,* in patients receiving oral doses from 5 to 60 mg fluphenazine hydrochloride daily, showed that 20 mg fluphenazine hydrochloride daily was equivalent to 25 mg (1 mL) Prolixin Decanoate every three weeks. This represents an approximate conversion ratio of mL ( mg) of decanoate every three weeks for every 10 mg of fluphenazine hydrochloride daily.
Fluphenazine is contraindicated in patients with hematological disease. Hematologic effects including leukopenia, neutropenia, and agranulocytosis have been associated with antipsychotic use. A history of drug-induced leukopenia or neutropenia or pre-existing low white blood cell (WBC) count may increase the likelihood of developing hematologic effects during treatment with an antipsychotic medication. Patients with a history of clinically significant low WBC count or drug-induced leukopenia/neutropenia should have frequent complete blood count (CBC) assessments during the first few months of treatment. Discontinuation of the antipsychotic should be considered if a clinically significant decline in WBC occurs in the absence of an identifiable cause. Patients with clinically significant neutropenia should be closely monitored for fever and infection, and appropriate medical intervention should be instituted if necessary. Fluphenazine should be discontinued in patients with severe neutropenia (ANC < 1000/mm3); ongoing medical care is recommended until the symptoms resolve. Patients with bone marrow suppression secondary to phenothiazine use should not be re-exposed to phenothiazine treatment.