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|Mellaril

Mellaril

Generic name: Thioridazine hydrochloride
Brand names: Mellaril

Why is Mellaril prescribed?

Mellaril combats the crippling mental disorder known as schizophrenia (a severe loss of contact with reality). Because Mellaril has been known to cause dangerous heartbeat irregularities, it is usually prescribed only when at least two other medications have failed.

Most important fact about Mellaril

The danger of potentially fatal cardiac irregularities increases when Mellaril is combined with any medication that prolongs a part of the heartbeat known as the QTc interval. Many of the drugs prescribed for heartbeat irregularities (including Cordarone, Inderal, Quinaglute, Quinidex, and Rythmol) prolong the QTc interval and should never be combined with Mellaril. Other drugs to avoid when taking Mellaril include fluvoxamine, Norvir, Paxil, Pindolol, Prozac, Rescriptor, and Tagamet. Make sure the doctor knows you are taking Mellaril whenever a new drug is prescribed.

How should you take Mellaril?

If you are taking Mellaril in a liquid concentrate form, you can dilute it with a liquid such as distilled water, soft tap water, or juice just before taking it.

Do not change from one brand of thioridazine to another without consulting your doctor.

--If you miss a dose...

If you take 1 dose a day and remember later in the day, take the dose immediately. If you don"t remember until the next day, skip the dose and go back to your regular schedule.

If you take more than 1 dose a day and remember the forgotten dose within an hour or so after its scheduled time, take it immediately. If you don"t remember until later, skip the dose and go back to your regular schedule.

Never try to "catch up" by doubling a dose.

--Storage instructions...

Store at room temperature, tightly closed, in the container the medication came in.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Mellaril.

• More common side effects may include:
  Blurred vision, breast development in men, breast milk secretion, constipation, diarrhea, drowsiness, dry mouth, impotence, nausea, swelling in the arms and legs (edema), tardive dyskinesia (see "Special warnings about Mellaril), vomiting

Why should Mellaril not be prescribed?

Due to the danger of cardiac irregularities, Mellaril must never be combined with drugs that increase its effects or prolong the part of the heartbeat known as the QTc interval. (See "Most important fact about Mellaril.") It is also important to avoid combining Mellaril with excessive amounts of central nervous system depressants such as alcohol, barbiturates, or narcotics. Do not take Mellaril if you have heart disease accompanied by severe high or low blood pressure.

Special warnings about Mellaril

Mellaril may cause tardive dyskinesia--a condition marked by involuntary muscle spasms and twitches in the face and body. This condition may be permanent, and appears to be most common among the elderly, especially women. Ask your doctor for information about this possible risk.

Drugs such as Mellaril are also known to cause a potentially fatal condition known as Neuroleptic Malignant Syndrome. Symptoms of this problem include high fever, rigid muscles, altered mental status, sweating, fast or irregular heartbeat, and changes in blood pressure. If you develop these symptoms, see your doctor immediately. Mellaril therapy may have to be permanently discontinued.

Animal studies suggest that antipsychotics such as Mellaril may increase the risk of breast cancer, although human studies have not confirmed such a risk. If you have a history of breast cancer, be sure to see your doctor regularly for checkups.

In rare cases, Mellaril has been known to trigger blood disorders and seizures. It can cause dizziness or faintness when you first stand up. High doses can also cause vision problems, including blurring, brownish coloring of vision, and poor night vision.

This drug may impair your ability to drive a car or operate potentially dangerous machinery. Do not participate in any activities that require full alertness until you are certain the drug will not interfere.

Possible food and drug interactions when taking Mellaril

Remember that combining Mellaril with certain drugs can increase the danger of potentially fatal heartbeat irregularities. Among the drugs to avoid are the following:

Amiodarone (Cordarone)
Cimetidine (Tagamet)
Delavirdine (Rescriptor)
Fluoxetine (Prozac)
FluvoxamineParoxetine (Paxil)
Pindolol
Propafenone (Rythmol)
Propranolol (Inderal)
Quinidine (Quinaglute, Quinidex)
Ritonavir (Norvir)

Check with your doctor before adding any new drug to your regimen. Remember, too, that extreme drowsiness and other potentially serious effects can result if Mellaril is combined with alcohol or other central nervous system depressants such as narcotics, painkillers, and sleeping medications.

Special information if you are pregnant or breastfeeding

Pregnant women should use Mellaril only if clearly needed. If you are pregnant or plan to become pregnant, inform your doctor immediately.

There is no information on the effects of Mellaril during breastfeeding. The doctor may advise you to stop nursing until your treatment with Mellaril is finished.

Recommended dosage

Your doctor will tailor your dose to your needs, using the smallest effective amount.

ADULTS

The starting dose ranges from 50 to 100 milligrams 3 times a day. Your doctor may gradually increase your dosage to as much as 800 milligrams a day, taken in 2 to 4 small doses. Once your symptoms improve, your doctor will decrease the dosage to the lowest effective amount.

CHILDREN

The usual starting dose for schizophrenic children is 0.5 milligrams per 2.2 pounds of body weight per day, divided into smaller doses. The dose may be gradually increased to a maximum of 3 milligrams per 2.2 pounds per day.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of Mellaril can be fatal. If you suspect an overdose, seek medical help immediately.

• Symptoms of Mellaril overdose may include:
  Agitation, blurred vision, coma, confusion, constipation, difficulty breathing, dilated or constricted pupils, diminished flow of urine, dry mouth, dry skin, excessively high or low body temperature, extremely low blood pressure, fluid in the lungs, heart abnormalities, inability to urinate, intestinal blockage, nasal congestion, restlessness, sedation, seizures, shock