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Central Nervous System

Serious: Convulsions have been reported. Extrapyramidal symptoms (E.P.S.) may occur, such as dystonia, torticoilis, oculogyric crises, akathisia and gait disturbances. Others: Occasional cases of dizziness, headache, fever and restlessness have been reported.

Drowsiness may occur on occasion, following an initial injection. Generally this effect tends to subside with continued therapy or is usually alleviated by a reduction in dosage.

Autonomic Nervous System

Dryness of the mouth and nose, blurred vision, tinnitus. An occasional case of sialorrhea together with altered gustatory sensation has been observed.

Endocrine System

Peripheral edema of the arms, hands and face.

Hepatotoxicity

An occasional case of cholestatic jaundice has been observed.

Other

An occasional case of cerebral vascular spasm and trigeminal neuralgia has been reported.

Phenothiazine Derivatives

The physician should be aware that the following have occurred with one or more phenothiazines and should be considered whenever one of these drugs is used:

Blood Dyscrasias: Serious - Agranulocytosis, leukopenia, thrombocytopenia, aplastic anemia, pancytopenia. Other: Eosinophilia, leukocytosis.

Autonomic Reactions: Miosis, obstipation, anorexia, paralytic ileus.

Cutaneous Reactions: Serious - Erytherna, exfoliative dermatitis, contact dermatitis.

Hepatotoxicity: Serious - Jaundice, biliary stasis.

Cardiovascular Effects: Serious - Hypotension, rarely leading to cardiac arrest; electrocardiographic (ECG) changes.

Extrapyramidal Symptoms: Serious - Akathisia, agitation, motor restlessness, dystonic reactions, trismus, torticollis, opisthotonos, oculogyric crises, tremor, muscular rigidity, akinesia - some of which have persisted for several months or years especially in patients of advanced age with brain damage.

Endocrine Disturbances: Menstrual irregularities, altered libido, gynecomastia, weight gain. False positive pregnancy tests have been reported.

Urinary Disturbances: Retention, incontinence.

Allergic Reactions: Serious - Fever, laryngeal edema, angioneurotic edema, asthma.

Others: Hyperpyrexia. Behavioral effects suggestive of a paradoxical reaction have been reported. These include excitement, bizarre dreams, aggravation of psychoses and toxic confusional states. While there is no evidence at present that ECG changes observed in patients receiving phenothiazines are in any way precursors of any significant disturbance of cardiac rhythm, it should be noted that sudden and unexpected deaths apparently due to cardiac arrest have been reported in a few instances in hospitalized psychotic patients previously showing characteristic ECG changes. A peculiar skin-eye syndrome has also been recognized as a side effect following long-term treatment with certain phenothiazines. This reaction is marked by progressive pigmentation of areas of the skin or conjunctiva and/or accompanied by discoloration of the exposed sclera and cornea. Opacities of the anterior lens and cornea described as irregular or stellate in shape have also been reported.

DRUG ABUSE AND DEPENDENCE

TORECAN (thiethylperazine) is not a controlled substance.

Phenothiazines are capable of potentiating CNS depressants (e.g., barbiturates, anesthetics, opiates, alcohol, etc.) as well as atropine and phosphorous insecticides.

Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.