From the FDA Drug Label
DOSAGE AND ADMINISTRATION: ... Dosage should not exceed 100 mg. If doses greater than 50 mg are deemed necessary, the next dose and succeeding doses should be increased cautiously in increments of 12. 5 mg. The maximum allowed dose of Fludicate (fluphenazine decanoate) is 100 mg 1.
From the Research
The maximum allowed dose of fluphenazine decanoate (Fludicate) should not exceed 100 mg every 2-3 weeks, with typical maintenance dosing ranging from 12.5 to 50 mg administered intramuscularly every 2-4 weeks, as higher doses increase the risk of extrapyramidal symptoms, including tardive dyskinesia, akathisia, and parkinsonism 2. When initiating treatment, it's recommended to start with a lower test dose (12.5-25 mg) to assess tolerability before increasing to therapeutic levels.
- Fluphenazine decanoate is a long-acting antipsychotic medication used primarily for schizophrenia and other psychotic disorders.
- The medication is administered as a deep intramuscular injection, preferably in the gluteal muscle.
- Dosing should be individualized based on the patient's clinical response and side effect profile.
- Regular monitoring for extrapyramidal symptoms is essential, and anticholinergic medications should be available to manage acute dystonic reactions 3, 4.
- Studies have shown that lower doses of fluphenazine decanoate may be effective in preventing psychotic relapse while minimizing total cumulative dosage 5.
- However, the relationship between fluphenazine dosage and acute outcome is complex, and higher doses may be associated with greater clinical improvement but also with a higher incidence of extrapyramidal symptoms 6.
- Therefore, the dose of fluphenazine decanoate should be carefully titrated to achieve the optimal balance between efficacy and tolerability, with a focus on minimizing the risk of extrapyramidal symptoms and other adverse effects 2.