Discontinue if NMS manifesting hyperthermia, altered mental status, muscular rigidity, autonomic instability & increased creatine phosphokinase occurs; in neutrophil count <1 x 10
9/L; jaundice develops. Consider treatment discontinuation in patients experiencing severe intensity of somnolence. Consider dose reduction or treatment discontinuation if signs & symptoms of tardive dyskinesia appear. Somnolence & related symptoms eg, sedation. Dysphagia & aspiration; VTE. Increased risk of suicidal thoughts, self-harm & suicide (suicide-related events); incidence of extrapyramidal symptoms. Hyperglycaemia or exacerbation of pre-existing diabetes. Increased triglycerides, LDL & total cholesterol & decreased HDL cholesterol. Acute w/drawal symptoms eg, nausea, vomiting, insomnia, headache, diarrhoea, dizziness & irritability after abrupt cessation of high dose treatment. Patients w/ known CV & cerebrovascular disease, or other conditions predisposing to hypotension; history of seizures; family history of QT prolongation; risk factors for stroke & aspiration pneumonia. Consider dose reduction or more gradual titration if orthostatic hypotension occur especially during initial dose-titration period. Observe patients for signs & symptoms of infection & neutrophil counts. Perform clinical monitoring in diabetic patients & patients w/ risk factors for developing DM. Manage lipid changes clinically. W/draw treatment gradually over a period of at least 1-2 wk. Identify all possible risk factors for VTE before & during treatment. Concomitant use w/ medications increasing QTc interval & neuroleptics, especially in elderly, patients w/ congenital long QT syndrome, CHF, heart hypertrophy, hypokalaemia or hypomagnesaemia. Hepatic impairment. Pregnancy. Avoid breastfeeding. Childn & adolescents <18 yr. Changes in thyroid function tests in childn & adolescents. Not to be used for dementia-related psychosis in elderly. Elderly.
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