Clinical data
Trade namesProlixin, Modecate, Moditen others
License data
  • AU: C
Routes of
By mouth, Intramuscular injection, depot injection (fluphenazine decanoate)
Drug classTypical antipsychotic
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability2.7% (by mouth)
Elimination half-lifeIM 15 hours (HCL), 7–10 days (decanoate)[2]
ExcretionUrine, feces
  • 2-[4-[3-[2-(trifluoromethyl)-10H-phenothiazin-10-yl]propyl]piperazin-1-yl]ethanol
CAS Number
PubChem CID
CompTox Dashboard (EPA)
ECHA InfoCard100.000.639 Edit this at Wikidata
Chemical and physical data
Molar mass437.53 g·mol−1
3D model (JSmol)
  • FC(F)(F)c2cc1N(c3c(Sc1cc2)cccc3)CCCN4CCN(CCO)CC4
  • InChI=1S/C22H26F3N3OS/c23-22(24,25)17-6-7-21-19(16-17)28(18-4-1-2-5-20(18)30-21)9-3-8-26-10-12-27(13-11-26)14-15-29/h1-2,4-7,16,29H,3,8-15H2 checkY

Fluphenazine, sold under the brand name Prolixin among others, is a high-potency typical antipsychotic medication.[2] It is used in the treatment of chronic psychoses such as schizophrenia,[2][3] and appears to be about equal in effectiveness to low-potency antipsychotics like chlorpromazine.[4] It is given by mouth, injection into a muscle, or just under the skin.[2] There is also a long acting injectable version that may last for up to four weeks.[2] Fluphenazine decanoate, the depot injection form of fluphenazine, should not be used by people with severe depression.[5]

Common side effects include movement problems, sleepiness, depression and increased weight.[2] Serious side effects may include neuroleptic malignant syndrome, low white blood cell levels, and the potentially permanent movement disorder tardive dyskinesia.[2] In older people with psychosis as a result of dementia it may increase the risk of dying.[2] It may also increase prolactin levels which may result in milk production, enlarged breasts in males, impotence, and the absence of menstrual periods.[2] It is unclear if it is safe for use in pregnancy.[2]

Fluphenazine is a typical antipsychotic of the phenothiazine class.[2] Its mechanism of action is not entirely clear but believed to be related to its ability to block dopamine receptors.[2] In up to 40% of those on long term phenothiazines, liver function tests become mildly abnormal.[6]

Fluphenazine came into use in 1959.[7] The injectable form is on the World Health Organization's List of Essential Medicines.[8] It is available as a generic medication.[2] It was discontinued in Australia in 2017.[9]

Medical use

A 2018 Cochrane review found that fluphenazine was an imperfect treatment and other inexpensive drugs less associated with side effects may be an equally effective choice for people with schizophrenia.[10]

Side effects


The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse.[11] Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite.[12] Other symptoms may include restlessness, increased sweating, and trouble sleeping.[12] Less commonly there may be a feeling of the world spinning, numbness, or muscle pains.[12] Symptoms generally resolve after a short period of time.[12]

There is tentative evidence that discontinuation of antipsychotics can result in psychosis.[13] It may also result in reoccurrence of the condition that is being treated.[14] Rarely tardive dyskinesia can occur when the medication is stopped.[12]



See also: Antipsychotic § Pharmacodynamics, and Antipsychotic § Comparison of medications

Fluphenazine acts primarily by blocking post-synaptic dopaminergic D2 receptors in the basal ganglia, cortical and limbic system. It also blocks α1 adrenergic receptors, muscarinic M1 receptors, and histaminergic H1 receptors.[15][16]

Site Ki (nM) Action Ref
5-HT1A 145–2829 ND [17]
5-HT1B 334 ND [17]
5-HT1D 334 ND [17]
5-HT1E 540 ND [17]
5-HT2A 3.8–98 ND [17]
5-HT2B ND ND [17]
5-HT2C 174–2,570 ND [17]
5-HT3 4,265– >10,000 ND [17]
5-HT5A 145 ND [17]
5-HT6 7.9–38 ND [17]
5-HT7 8 ND [17]
D1 14.45 ND [17]
D2 0.89 ND
D2L ND [17]
D3 1.412 ND [17]
D4 89.12 ND [17]
D5 95–2,590 ND [17]
α1A 6.4–9 ND [17]
α1B 13 ND [17]
α2A 304–314 ND [17]
α2B 181.6–320 ND [17]
α2C 28.8–122 ND [17]
β1 >10,000 ND [17]
β2 >10,000 ND [17]
H1 7.3–70 ND [17]
H2 560 ND [17]
H3 1,000 ND [17]
H4 >10,000 ND [17]
M1 1,095-3,235.93 ND [17]
M2 2,187.76–7,163 ND [17]
M3 1441–1445.4 ND [17]
M4 5,321 ND [17]
M5 357 ND [17]
SERTTooltip Serotonin transporter ND ND [17]
NETTooltip Norepinephrine transporter ND ND [17]
DATTooltip Dopamine transporter ND ND [17]
ND ND [17]
Values are Ki (nM). The smaller the value, the more strongly the drug binds to the site. All data are for human cloned proteins, except 5-HT3 (rat), D4 (human/rat), H3 (guinea pig), and NMDA/PCP (rat).[17]


Pharmacokinetics of long-acting injectable antipsychotics
Medication Brand name Class Vehicle Dosage Tmax t1/2 single t1/2 multiple logPc Ref
Aripiprazole lauroxil Aristada Atypical Watera 441–1064 mg/4–8 weeks 24–35 days ? 54–57 days 7.9–10.0
Aripiprazole monohydrate Abilify Maintena Atypical Watera 300–400 mg/4 weeks 7 days ? 30–47 days 4.9–5.2
Bromperidol decanoate Impromen Decanoas Typical Sesame oil 40–300 mg/4 weeks 3–9 days ? 21–25 days 7.9 [18]
Clopentixol decanoate Sordinol Depot Typical Viscoleob 50–600 mg/1–4 weeks 4–7 days ? 19 days 9.0 [19]
Flupentixol decanoate Depixol Typical Viscoleob 10–200 mg/2–4 weeks 4–10 days 8 days 17 days 7.2–9.2 [19][20]
Fluphenazine decanoate Prolixin Decanoate Typical Sesame oil 12.5–100 mg/2–5 weeks 1–2 days 1–10 days 14–100 days 7.2–9.0 [21][22][23]
Fluphenazine enanthate Prolixin Enanthate Typical Sesame oil 12.5–100 mg/1–4 weeks 2–3 days 4 days ? 6.4–7.4 [22]
Fluspirilene Imap, Redeptin Typical Watera 2–12 mg/1 week 1–8 days 7 days ? 5.2–5.8 [24]
Haloperidol decanoate Haldol Decanoate Typical Sesame oil 20–400 mg/2–4 weeks 3–9 days 18–21 days 7.2–7.9 [25][26]
Olanzapine pamoate Zyprexa Relprevv Atypical Watera 150–405 mg/2–4 weeks 7 days ? 30 days
Oxyprothepin decanoate Meclopin Typical ? ? ? ? ? 8.5–8.7
Paliperidone palmitate Invega Sustenna Atypical Watera 39–819 mg/4–12 weeks 13–33 days 25–139 days ? 8.1–10.1
Perphenazine decanoate Trilafon Dekanoat Typical Sesame oil 50–200 mg/2–4 weeks ? ? 27 days 8.9
Perphenazine enanthate Trilafon Enanthate Typical Sesame oil 25–200 mg/2 weeks 2–3 days ? 4–7 days 6.4–7.2 [27]
Pipotiazine palmitate Piportil Longum Typical Viscoleob 25–400 mg/4 weeks 9–10 days ? 14–21 days 8.5–11.6 [20]
Pipotiazine undecylenate Piportil Medium Typical Sesame oil 100–200 mg/2 weeks ? ? ? 8.4
Risperidone Risperdal Consta Atypical Microspheres 12.5–75 mg/2 weeks 21 days ? 3–6 days
Zuclopentixol acetate Clopixol Acuphase Typical Viscoleob 50–200 mg/1–3 days 1–2 days 1–2 days 4.7–4.9
Zuclopentixol decanoate Clopixol Depot Typical Viscoleob 50–800 mg/2–4 weeks 4–9 days ? 11–21 days 7.5–9.0
Note: All by intramuscular injection. Footnotes: a = Microcrystalline or nanocrystalline aqueous suspension. b = Low-viscosity vegetable oil (specifically fractionated coconut oil with medium-chain triglycerides). c = Predicted, from PubChem and DrugBank. Sources: Main: See template.


Fluphenazine came into use in 1959.[7]


The injectable form is on the World Health Organization's List of Essential Medicines.[8] It is available as a generic medication.[2] It was discontinued in Australia in 2017.[9]


In horses, it is sometimes given by injection as an anxiety-relieving medication, though there are many negative common side effects and it is forbidden by many equestrian competition organizations.[28]


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