Mellaril Side Effects

Generic Name: thioridazine

Please note - some side effects for Mellaril may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects by Body System

Nervous system

Nervous system side effects including drowsiness have occasionally been reported. Pseudoparkinsonism and other extrapyramidal symptoms have infrequently been reported. Nocturnal confusion, hyperactivity, lethargy, psychotic reactions, restlessness, and headache have been reported extremely rarely.

Drowsiness has been reported to subside with continuation of therapy or a reduction in dosage.

Cardiovascular

Cardiovascular side effects including prolongation of the QTc interval have been reported. Prolongation of the QTc interval occurs in a dose related manner which has been associated with torsades de pointes type arrhythmias and sudden death. A case of acute hypotension and a case of massive edema have also been reported.

Baseline ECG and serum potassium levels are recommend for patients being considered for treatment with thioridazine. Thioridazine is not recommended for use in patients with a QTc interval greater than 450 msec. It is recommended that serum potassium levels be normalized before initiation of therapy.

Once the patient is receiving thioridazine, periodic ECG's and serum potassium levels are recommended. Discontinuation of therapy is recommended if patients are found to have a QTc interval over 500 msec.

Gastrointestinal

Gastrointestinal side effects including dryness of the mouth, constipation, nausea, vomiting, and diarrhea have been reported. Obstipation, anorexia, and paralytic ileus has been reported with the use of phenothiazine derivatives.

Ocular

Ocular side effects including retinopathy and blurred vision have been reported. Miosis has been reported with the use of phenothiazine derivatives.

Respiratory

Respiratory side effects including nasal stuffiness have been reported.

Dermatologic

Dermatologic side effects including pallor have been reported. Dermatitis and urticarial skin eruptions have been reported infrequently. Photosensitivity has been reported extremely rarely. Erythema, exfoliative dermatitis, and contact dermatitis have been reported with the use of phenothiazine derivatives.

Endocrine

Endocrine side effects including galactorrhea, breast engorgement, amenorrhea, inhibition of ejaculation and peripheral edema have been reported. Menstrual irregularities, altered libido, gynecomastia, lactation, weight gain, edema, and false positive pregnancy tests have been reported with the use of phenothiazine derivatives.

Other

Other side effects including parotid swelling have been reported.

Hematologic

Hematologic side effects including agranulocytosis have been report. Leukopenia, eosinophilia, thrombocytopenia, anemia, aplastic anemia, and pancytopenia have been reported with the use of phenothiazine derivatives.

Hepatic

Hepatic side effects including individual cases of cholestasis, elevated transaminase levels, and clinical jaundice have been reported. Biliary stasis have been reported with the use of phenothiazine derivatives.

Psychiatric

Psychiatric side effects including agitation have been reported in patients receiving phenothiazine derivatives. A case report of thioridazine induced toxic psychosis has also been reported.

Musculoskeletal

Musculoskeletal side effects including tardive dyskinesia has been reported with the use of phenothiazine derivatives.

Genitourinary

Genitourinary side effects including ejaculatory problems (60% in a study of 57 male patients) have been reported. One third of these patients experienced retrograde ejaculation. Urinary incontinence and priapism have also been reported. Urinary retention been reported with the use of phenothiazine derivatives.

General

General side effects including hyperpyrexia have been reported with the use of phenothiazine derivatives. Behavioral effects suggestive of a paradoxical reaction which included excitement, bizarre dreams, aggravation of psychosis and toxic confusional states have also been reported with the use of phenothiazine derivatives.

Metabolic

Metabolic side effects include one case of exacerbation of diabetes which has been reported.

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