Quick Facts
Generic NameFluphenazine
Brand NameProlixin
Drug ClassFGA
FDA Approved1959
Starting Dose2.5–5mg/day
Typical Range5–20mg/day
Max Dose40mg/day
Half-Life15–30 hours (oral); 7–10 days (decanoate)
MetabolismCYP2D6
Generic AvailableAlways generic
What Is Prolixin?
Fluphenazine (brand name Prolixin) is a first-generation (typical) antipsychotic (FGA) prescribed for schizophrenia, and other psychiatric conditions. Long-acting decanoate injectable (every 2–4 weeks) — one of the oldest LAIs available. High potency. Low sedation but high EPS risk. Useful when oral medication adherence is a concern. Being replaced by SGA LAIs but still used.
At Psychiatry Telemed, fluphenazine is prescribed and monitored by board-certified psychiatrists who understand the nuances of FGA pharmacology — selecting the right dose, managing side effects, monitoring drug interactions, and optimizing your treatment through consistent monthly medication management appointments.
Fluphenazine (Prolixin) — FGA medication for psychiatric care
ManufacturerVarious (originally Squibb)
How Prolixin Affects Neurotransmitters
How Prolixin Works
Fluphenazine is a high-potency phenothiazine FGA with strong D2 antagonism. Similar EPS profile to haloperidol. The decanoate (long-acting injectable) formulation provides 2–4 weeks of antipsychotic coverage per injection, ensuring medication adherence.
Efficacy: Prolixin vs. Comparators
Efficacy Comparison
Response & remission rates vs. comparators (Cipriani et al. meta-analysis)
Data from published meta-analyses. Individual response may vary.
Conditions Treated with Prolixin
Schizophrenia
FDA-approved. High-potency FGA with long-acting injectable option.
Learn About SchizophreniaConsidering Prolixin?
Board-certified psychiatrists can determine if fluphenazine is right for you.
Dosage Information
| Indication | Starting Dose | Typical Range | Maximum |
|---|---|---|---|
| Schizophrenia | 2.5–5mg/day | 5–20mg/day | 40mg/day |
Brain Regions Targeted by Prolixin
Side Effects
Like all medications, fluphenazine has potential side effects. Most are mild, occur early in treatment, and resolve within 1–2 weeks. Your psychiatrist monitors at every appointment.
Common Side Effects
EPS (high risk)DrowsinessDry MouthConstipationBlurred Vision
Less Common
Orthostatic HypotensionWeight GainPhotosensitivityProlactin Elevation
Serious (Seek Immediate Help)
Tardive DyskinesiaNMSAgranulocytosis (rare)SeizuresHepatotoxicity
Side Effect Profile: Prolixin vs. Class Average
Side Effect Profile
Incidence rates from FDA prescribing information vs. class average
Percentages from clinical trial data. Actual experience may differ.
⚠️ FDA Black Box Warning
Elderly dementia patients — increased mortality.
Drug Interactions
Major Interactions
CNS depressants, anticholinergics, CYP2D6 inhibitors
CYP Metabolism
Substrate of CYP2D6.
Alcohol
Avoid alcohol during fluphenazine treatment. Both affect the CNS, increasing sedation and impairing judgment.
Generic Versions & Cost
Generic fluphenazine available since Always generic. Approximate cost: $4–15/month (oral); $30–60 (decanoate injection). FDA-certified bioequivalent to brand-name Prolixin.
Starting Prolixin: What to Expect
First Weeks
Fluphenazine is typically started at 2.5–5mg/day and increased gradually. Common initial side effects usually improve within 1–2 weeks. Full therapeutic benefit develops over 4–8 weeks.
When to Contact Your Psychiatrist
Contact your psychiatrist for: worsening depression/anxiety, thoughts of self-harm, unusual agitation, severe side effects, or any concerning changes.
Stopping Prolixin Safely
Never stop fluphenazine abruptly. Your psychiatrist will develop a gradual tapering schedule to minimize discontinuation effects.
Timeline: When Prolixin Starts Working
Timeline to Effectiveness
Expected improvement trajectory over the first 8 weeks
Based on clinical trial data. Full therapeutic effects may take 6–8 weeks.
Get Prolixin from a Board-Certified Psychiatrist
At Psychiatry Telemed, fluphenazine is prescribed following comprehensive evaluation. All Florida via HIPAA-compliant telepsychiatry. 1–3 days. $200 eval, $100 follow-up.
Frequently Asked Questions
Prescribed for schizophrenia.
Typically 2–4 weeks for initial improvement, 4–8 weeks for full benefit.
Common: eps (high risk), drowsiness, dry mouth, constipation, blurred vision. Most resolve within 1–2 weeks.
No. Not habit-forming but should not be stopped abruptly — gradual tapering recommended.
Long-acting decanoate injectable (every 2–4 weeks) — one of the oldest LAIs available. High potency. Low sedation but high EPS risk. Useful when oral medication adherence is a concern. Being replaced
Alcohol should be avoided — increases sedation, impairs judgment, and may worsen symptoms.
Resources
Medical Disclaimer: Educational only. Consult a psychiatrist before starting/stopping medication. Crisis: call 988 or 911.
Last reviewed: