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Package leaflet: Information for the patient

Depixol® 20 mg/ml solution for injection
flupentixol decanoate
Read all of this leaflet carefully before you start using
this medicine
• Keep this leaflet. You may need to read it again
• If you have any further questions, ask your doctor,
pharmacist or nurse
• This medicine has been prescribed for you only. Do
not pass it on to others. It may harm them, even if
their signs of illness are the same as yours
• If you get any side effects, talk to your doctor,
pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Depixol Injection is and what it is used for
2. What you need to know before Depixol Injection is
3. How Depixol Injection is given
4. Possible side effects
5. How to store Depixol Injection
6. Contents of the pack and other information
1. What Depixol Injection is and what it is used for
The name of your medicine is Depixol 20 mg/ml solution
for injection (called Depixol Injection in this leaflet).


Depixol Injection contains the active substance
flupentixol decanoate. Depixol Injection belongs to a
group of medicines known as antipsychotics (also called
These medicines act on nerve pathways in specific
areas of the brain and help to correct certain chemical
imbalances in the brain that are causing the symptoms of
your illness.
Depixol Injection is used for the treatment of
schizophrenia and other psychoses.
Your doctor, however, may prescribe Depixol Injection
for another purpose. Ask your doctor if you have
any questions about why Depixol Injection has been
prescribed for you.
2. What you need to know before Depixol Injection is
Depixol Injection is not given if you
• are allergic (hypersensitive) to flupentixol, other
thioxanthine drugs or antipsychotic drugs or any of the
other ingredients of this medicine (listed in section 6)
• are feeling less alert than usual or are drowsy or sleepy,
or have serious problems with your blood circulation
• are excited or agitated
Warnings and precautions
Talk to your doctor, pharmacist or nurse before Depixol
Injection is given if you:
• have a heart condition, including an irregular heart
beat (such as a slower heart beat); have had a recent
heart attack or have problems that cause ankle swelling
or shortness of breath
• have severe breathing problems (such as asthma or
• have liver, kidney or thyroid problems
• suffer from epilepsy, or have been told that you are at
risk of having fits (for example because of a brain injury
or because of alcohol withdrawal)
• suffer from Parkinson’s disease, or myasthenia gravis
(a condition causing severe muscular weakness)
• have an enlarged prostate or suffer from a condition
known as phaeochromocytoma (a rare type of cancer of
a gland near the kidney)
• suffer from glaucoma (raised pressure within the eye)
• have risk factors for stroke (e.g. smoking, hypertension)
• have too little potassium or magnesium in your blood
or a family history of irregular heart beats
• use other antipsychotic medicines
• suffer from diabetes
• or someone else in your family has a history of blood
clots, as medicines like these have been associated
with formation of blood clots
• are treated for cancer
Children and adolescents
Depixol Injection is not recommended in these patients.
Thoughts of suicide and worsening of your depression
or anxiety disorder
If you are depressed and/or have anxiety disorders
you can sometimes have thoughts of harming or killing
yourself. These may be increased when first starting
antidepressants, since these medicines all take time to
work, usually about two weeks but sometimes longer.
You may be more likely to think like this:
• If you have previously had thoughts about killing or
harming yourself
• If you are a young adult. Information from clinical trials
has shown an increased risk of suicidal behaviour
in adults aged less than 25 years with psychiatric
conditions who were treated with an antidepressant
If you have thoughts of harming or killing yourself at any
time, contact your doctor or go to a hospital straight
You may find it helpful to tell a relative or close friend
that you are depressed or have an anxiety disorder, and
ask them to read this leaflet.
You might ask them to tell you if they think your
depression or anxiety is getting worse, or if they are
worried about changes in your behaviour.
Other medicines and Depixol Injection
Tell your doctor or pharmacist if you are taking, have
recently taken or might take any other medicines.
The following medicines should not be taken at the same
time as Depixol Injection:
• Medicines that change the heartbeat (quinidine,
amiodarone, sotalol, dofetilide, erythromycin,
moxifloxacin, cisapride, lithium)
• Other antipsychotic medicines

Tell your doctor or pharmacist if you are taking any of the
following medicines:
• Tricyclic anti-depressants
• Barbiturates or other medicines that make you feel
• Anticoagulant drugs used to prevent blood clots (e.g.
• Anticholinergic drugs (contained in some cold, allergy
or travel sickness remedies as well as other medicines)
• Metoclopramide (used to treat nausea and other
stomach conditions)
• Piperazine (used to treat worm infections)
• Levodopa or other medicines used to treat Parkinson’s
• Sibutramine (used to reduce appetite)
• Digoxin (to control heart rhythm)
• Corticosteroids (e.g. prednisolone)
• Medicines used to lower the blood pressure such as
hydralazine, alpha blockers (e.g. doxazosin) betablockers, methyldopa, clonidine or guanethidine
• Medicines that cause a disturbed water or salt balance
(too little potassium or magnesium in your blood)
• Medicines known to increase the concentration of
flupentixol in your blood
• Medicines used to treat epilepsy
• Medicines used to treat diabetes

GB-MT-067-60-20-13410 REG



Depixol Injection can reduce the effect of adrenaline
(epinephrine) and similar drugs.
Tell your doctor, dentist, surgeon or anaesthetist before
any operation as Depixol Injection can increase the effects
of general anaesthetics, muscle relaxing drugs and drugs
used to prevent clots.


Depixol Injection with alcohol
Depixol Injection may increase the sedative effects of
alcohol making you drowsier. It is recommended not to
drink alcohol during treatment with Depixol Injection.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you might be
pregnant or are planning to have a baby, ask your doctor
or pharmacist for advice before taking this medicine.

If you are pregnant or think you might be pregnant, tell
your doctor. Depixol Injection should not be used during
pregnancy unless clearly necessary.


The following symptoms may occur in newborn babies,
of mothers that have used Depixol Injection in the last
trimester (last three months of their pregnancy): shaking,
muscle stiffness and/ or weakness, sleepiness, agitation,
breathing problems, and difficulty in feeding. If your baby
develops any of these symptoms you may need to contact
your doctor.
If you are breast-feeding, ask your doctor for advice.
Depixol Injection should not be used when breast-feeding,
as small amounts of the medicine can pass into the breast
Flupentixol has been shown to affect fertility in animal
studies. Please ask your doctor for advice.
Driving and using machines
There is a risk of feeling drowsy and dizzy when being
treated with Depixol Injection, especially at the start of
your treatment. If this happens do not drive or use any
tools or machines until you know you are not affected in
this way.
Do not drive if you have blurred vision.
3. How Depixol Injection is given
A small amount of Depixol Injection is drawn up into a
syringe and then injected into the muscle of your buttock
or thigh.
Your doctor will decide on the correct amount of medicine
to give, and how often to give it. The medicine is slowly
released from the injection site so that a fairly constant
amount of medicine gets into your blood during the period
between each dose.
The usual dose lies between 50 mg every 4 weeks to
300 mg every 2 weeks but some patients require 400 mg
every week. If you need more than 2 ml of medicine it will
probably be divided between 2 injection sites.
If you haven’t received an injection like Depixol Injection
before, a small dose of 20 mg is usually given one week
before your normal dose to test how well you tolerate the
If you have been treated with Depixol tablets and you are
being transferred to Depixol Injection you may be asked to
continue taking the tablets for several days after the first
Your doctor may decide to adjust the amount given, or the
interval between injections, from time to time.
If you have liver problems, the level of flupentixol in your
blood may be checked.
Older patients (above 65 years)
Starting doses for older or frail patients are usually
reduced to a quarter or a half of the dosage range.
Use in children
Depixol Injection is not recommended for children.
Duration of treatment
It may take between four and six months before you feel
better. Your doctor will decide the duration of treatment.
If you feel that the effect of Depixol Injection is too strong
or weak, talk to your doctor.
It is important that you continue to receive your medicine
at regular intervals even if you are feeling completely well,
because the underlying illness may persist for a long time.
If you stop your treatment too soon your symptoms may

The following information is intended for healthcare professionals only:
Administration information for the healthcare professional
Depixol 20 mg/ml solution for injection
Consult the Summary of Product Characteristics for full information on this product
Depixol 20 mg/ml solution for injection should be administered by deep intramuscular injection into the upper
outer buttock or lateral thigh.
Note: As with all oil-based injections it is important to ensure, by aspiration before injection, that inadvertent
intravascular entry does not occur.
Injection volumes of greater than 2 ml should be distributed between two injection sites.
This product may be mixed in the same syringe with other products in the Depixol Injection range.
It should not be mixed with any other injection fluids.




If you get more Depixol Injection than you should
Your medicine will be given by your doctor or nurse.
In the unlikely event that you receive too much Depixol
Injection you may experience some symptoms.
Symptoms of overdose may include:
• Drowsiness
• Unconsciousness
• Muscle movements or stiffness
• Fits
• Low blood pressure, weak pulse, fast heart rate, pale
skin, restlessness
• High or low body temperature
• Changes in heart beat including irregular heart beat or
slow heart rate
You will receive treatment for any of these symptoms from
your doctor or nurse.
4. Possible side effects
Like all medicines, Depixol Injection can cause side
effects, although not everybody gets them. Older patients
tend to be more likely to suffer from some of these effects
than younger patients and this may mean your treatment
is supervised more closely.
Serious side effects
Stop taking Depixol and seek medical advice
immediately if you have any of the following allergic
• Difficulty in breathing
• Swelling of the face, lips, tongue or throat which causes
difficulty in swallowing or breathing
• Severe itching of the skin (with raised lumps)
Blood clots in the veins especially in the legs (symptoms
include swelling, pain and redness in the leg), which may
travel through blood vessels to the lungs causing chest
pain and difficulty in breathing. If you notice any of these
symptoms seek medical advice immediately.
If you get any of the following symptoms you should
contact your doctor immediately as your dose may need
to be reduced or stopped:
• High fever, unusual stiffness of the muscles and
changes in consciousness, especially if occurring with
sweating and fast heart rate. These symptoms may be
signs of a rare but serious condition called neuroleptic
malignant syndrome that has been reported with the
use of Depixol Injection and similar medicines
• Unusual movements of the mouth and tongue as
these may early signs of a condition known as tardive
• Unusual muscle movements (such as circular
movements of the eyes), stiffness, tremor and
restlessness (for example difficulty in sitting or
standing still) as these may be signs of a so-called
“extra pyramidal” reaction.
• In rare cases irregular heart beats (arrhytmias) may
have resulted in sudden death
• Any yellowing of the skin and the white in the eyes
(jaundice); your liver may be affected
Other side effects:
Side effects are most pronounced in the beginning of
the treatment and most of them usually wear off during
continued treatment.
• Throbbing or fast heartbeats
• Reduction in blood platelets (which increases the risk
of bleeding or bruising) and other blood cell changes
• Drowsiness
• Loss of co-ordination or altered muscle movements
(including unusual movements of the mouth, tongue
and eyeballs)
• Tremor
• Stiff or floppy muscles
• Dizziness
• Headache
• Poor concentration or confusion
• Rigidity of the whole body
• Speech problems
• Fits
• Blurred or abnormal vision
• Shortness of breath
• Dry mouth or increase in saliva
• Feeling sick or vomiting
• Indigestion or stomach pain
• Flatulence (wind), constipation or diarrhoea
• Abnormal urination (such as a decrease in the
frequency or amount)
• Increased sweating or greasy skin
• Itching, rashes or skin reactions (including sensitivity
to sunlight)
• Skin reactions at injection site
• Muscle pain
• Raised blood levels of glucose or the hormone
• Loss of control of blood sugar levels
• Changes in appetite or weight
• Low blood pressure
• Hot flushes
• General weakness or pain, tiredness or feeling unwell
• Abnormal liver function tests
• Unexpected excretion of breast milk
• Insomnia
• Depression
• Nervousness or agitation
• Reduction in your sex drive
• Men may experience breast enlargement or problems
with ejaculation or erections
• Women may experience an absence of menstrual
As with other medicines that work in a way similar to
flupentixol (the active ingredient of Depixol Injection), rare
cases of the following side effects have been reported:
• Slow heartbeat and abnormal ECG heart tracing.
• Life threatening irregular heart beats.
In older people with dementia, a small increase in the
number of deaths has been reported for patients taking
antipsychotics compared with those not receiving

Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist
or nurse. This includes any possible side effects not listed
in this leaflet. You can also report side effects directly (see
details below).
By reporting side effects you can help provide more
information on the safety of this medicine.
United Kingdom
Via the Yellow Card Scheme at:
Alternatively you can call Freephone 0808 100 3352
(available between 10am-2pm Monday – Friday) or fill in a
paper form available from your local pharmacy.
ADR Reporting
The Medicines Authority
Post-Licensing Directorate
203 Level 3, Rue D'Argens
GŻR-1368 Gżira
5. How to store Depixol Injection
Usually your doctor or nurse will store the medicine for
you. If you keep it at home:
• Keep this medicine out of the sight and reach of
• Do not use this medicine after the expiry date that is
printed on the label. The expiry date refers to the last
day of that month
• Keep the ampoules in the outer carton in order to
protect from light.
Do not throw away any medicines via wastewater or
household waste. Ask your pharmacist how to throw away
medicines you no longer use. These measures will help to
protect the environment.
6. Contents of the pack and other information
What Depixol Injection contains
The active substance is flupentixol decanoate.
Each millilitre (ml) of Depixol Injection contains 20 mg
flupentixol decanoate.
The other ingredient is thin vegetable oil (purified from
coconut oil).
What Depixol Injection looks like and contents of the
Depixol Injection is a clear, colourless or pale-yellow
Depixol Injection is available in:
Glass ampoules containing 1 ml (20 mg) or 2 ml (40 mg) in
cartons of 10 ampoules. Syringes containing 1 ml (20 mg)
or 2 ml (40 mg) in boxes of 5 syringes.
It is also available in single-packed vials of 10 ml (200 mg).
Not all pack sizes may be marketed.
Marketing Authorisation Holder
For any information about this medicine, please contact
the Marketing Authorisation holder:
Lundbeck Limited
Lundbeck House
Caldecotte Lake Business Park
Milton Keynes MK7 8LG
H. Lundbeck A/S
Ottiliavej 9
DK-2500 Valby
This leaflet was last revised in 10/2013.
To request a copy of this leaflet in braille, large print or
audio please call free of charge:
0800 198 5000
Please be ready to give the following information:
Product name
Depixol Injection

Product code number
PL 0458/0007R

This is a service provided by the Royal National Institute of
Blind People.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.