Pronunciation: moe-LIN-done HYE-droe-KLOR-ide
Class: Dihydroindolone derivative
- Tablets 5 mg
- Tablets 10 mg
- Tablets 25 mg
- Tablets 50 mg
Unknown. Exerts its effect on ascending reticular activating system.
Rapidly absorbed. T max is 1.5 h.
Metabolism is rapid.
Thirty-six metabolites are recognized with less than 2% to 3% unmetabolized molindone excreted in urine and feces.
Indications and Usage
Management of schizophrenia.
Severe CNS depression (eg, alcohol, barbiturates, narcotics) or comatose states; hypersensitivity to the drug.
Dosage and AdministrationAdults and Children 12 yr of age and older Initial dose
PO 50 to 75 mg/day, increasing dosage to 100 mg/day in 3 or 4 days. Patients with severe symptoms may require 225 mg/day. Start elderly and debilitated patients on lower dosage.Maintenance dose Mild symptoms
PO 5 to 15 mg 3 or 4 times daily.Moderate symptoms
PO 10 to 25 mg 3 or 4 times daily.Severe symptoms
PO 225 mg/day may be required.
Store at controlled room temperature (59° to 86°F). Protect from light.
Drug InteractionsPhenytoin, tetracyclines
This tablet's preparation contains calcium sulfate and may interfere with the absorption of phenytoin sodium and tetracycline.
Laboratory Test Interactions
None well documented.
Hypotension, tachycardia, transient, nonspecific T-wave changes.
Akathisia; depression; drowsiness; dystonic syndrome; euphoria; extrapyramidal reactions; hyperactivity; increased libido; Parkinson syndrome; seizures; tardive dyskinesia.
Constipation; dry mouth; nausea; salivation.
Amenorrhea; gynecomastia; initial heavy menses; priapism; urinary retention.
Altered liver function.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death compared with those taking placebo. Over a course of a 10-wk controlled trial, the rate of death in drug-treated patients was about 4.5% compared with 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either CV (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature.
Safety and efficacy not established in children younger than 12 yr of age.
Start therapy with a reduced dosage.
Molindone may have an antiemetic effect, which may obscure signs of intestinal obstruction or brain tumor.
Start therapy with a reduced dosage.
This potentially fatal condition has been reported in association with antipsychotic agents. Signs and symptoms include hyperpyrexia, muscle rigidity, altered mental status, irregular pulse or BP, tachycardia, diaphoresis, and cardiac arrhythmias.
Antipsychotic drugs elevate prolactin levels; elevation persists during chronic administration.
Convulsive seizures have been reported.
This syndrome of potentially irreversible, involuntary dyskinetic movements has occurred with other antipsychotic agents. Incidence appears to be highest among elderly patients, especially elderly women.
- Explain the risk of developing tardive dyskinesia.
- Advise patient that dose may be slowly increased until max benefit is achieved and not to take more than prescribed or increase the dose more rapidly than advised.
- Instruct patient not to stop taking molindone when symptoms have improved.
- Tell patient to immediately report high fever, muscle rigidity, involuntary body or facial movements, altered mental status, irregular pulse, or sweating to health care provider.
- Advise patient to avoid strenuous activity during periods of high temperature or humidity.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
- Advise patient to notify health care provider if excessive drowsiness occurs.
- Advise patient, family, or caregiver not to change the dose or stop taking molindone unless advised by health care provider.
- Instruct patient to avoid alcoholic beverages and other depressants while taking this medication.
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