Generic Thioridazine ( Thioridazine )

Buy cheap Generic Thioridazine (Thioridazine) without dr prescription at Canadian Pharmacy

At our US pharmacy, you can purchase Thioridazine 10 mg, 25 mg, 50 mg, and 100 mg without a prescription, with discreet and anonymous packaging delivered within 5-14 days across USA. Thioridazine is a first-generation antipsychotic that was used for decades to treat schizophrenia and other psychotic disorders. It belongs to the phenothiazine class and works by blocking dopamine receptors in the brain. Sales of thioridazine were discontinued in Canada in 2005 due to safety concerns, but the medication remains available in some other countries, and our pharmacy can source it for you. Would you like to try Thioridazine without a prescription?

Common Use Thioridazine

Thioridazine is a low-potency conventional antipsychotic. It blocks dopamine D2 receptors in the mesolimbic and mesocortical pathways, which helps reduce hallucinations, delusions, and disorganized thinking in schizophrenia. It also has strong anticholinergic and sedative effects, which is why it was often chosen for agitated or highly anxious patients. Among the older antipsychotics, thioridazine was known for causing fewer extrapyramidal symptoms, the stiff movements and tremors that plague drugs like haloperidol. But that advantage came at a price: it has a higher risk of heart rhythm problems, weight gain, and eye damage than most of its peers. Health Canada required all manufacturers to stop selling thioridazine products by September 30, 2005, after reports of cardiac arrhythmias and sudden death. It has been used in Canada since 1959 for schizophrenia, but the safety profile eventually led to its withdrawal. Thioridazine is not approved for treating behavioural problems in older adults with dementia.

Basic Thioridazine Information

• INN (International Nonproprietary Name): Thioridazine hydrochloride
• Brand names available in Canada: Mellaril® (original brand, marketed by Sandoz Canada Inc. and later Novartis Pharmaceuticals Canada Inc.); generics included Apo-Thioridazine (Apotex Inc.), Novo-Ridazine (Novopharm Limited), PMS-Thioridazine (Pharmascience Inc.), and Thioridazine tablets (Duchesnay Inc.)
• ATC Code: N05AC02
• Forms and dosages: Film-coated tablets – 10 mg, 25 mg, 50 mg, and 100 mg. An oral solution was also available in 5 mg/mL and 30 mg/mL strengths.
• Manufacturers in Canada: Sandoz Canada Inc. (Mellaril, DIN 00027537), Novartis Pharmaceuticals Canada Inc. (Mellaril, DIN 00027375), Apotex Inc. (Apo-Thioridazine, DIN 00575119), Novopharm Limited (Novo-Ridazine, DIN 00037508), Pharmascience Inc. (PMS-Thioridazine, DIN 00575119 and solution DIN 00776513), and Duchesnay Inc. (Thioridazine, DIN 00431133). All of these DINs are now cancelled after market.
• Registration status in Canada: Not approved. Health Canada required all manufacturers to stop sale by September 30, 2005. All product DINs have been cancelled after market. Thioridazine is no longer legally available in Canada through standard distribution.
• OTC / Rx classification: Prescription only (Rx) – never legally sold over-the-counter in Canadian pharmacies

Dosage & Direction

The dosing information below reflects the schedules used before thioridazine was withdrawn in Canada. For adults with schizophrenia, the usual starting dose was 50 mg to 100 mg taken three times daily. The dose was then gradually increased based on response and tolerability. The maintenance range was typically 200 mg to 800 mg per day, divided into two to four doses. The maximum daily dose was 800 mg. Some clinicians used a once-daily bedtime dosing schedule for convenience. For children aged 2 to 12 years with severe behavioural problems, the starting dose was 0.5 mg/kg per day in two to three divided doses, with a maximum of 3 mg/kg per day. For adolescents aged 13 to 18, the starting dose was 50 mg to 100 mg three times daily, with a maximum of 800 mg per day. Thioridazine was taken by mouth with or without food. Because it causes significant sedation and dizziness, the dose was often built up slowly. Patients were advised not to drive or operate machinery until they knew how the drug affected them. Alcohol was strictly forbidden during treatment. If you were taking thioridazine and missed a dose, you were told to take it as soon as you remembered, but to skip it if it was almost time for the next dose. Doubling up was never allowed. Routine eye exams and electrocardiograms were recommended during treatment because of the risks of retinal pigmentation and heart rhythm changes.

Precautions

Thioridazine carries a boxed warning about cardiac toxicity. It can prolong the QT interval on an electrocardiogram, which is a measure of how long the heart takes to recharge between beats. A prolonged QT interval can lead to a dangerous arrhythmia called torsades de pointes, which can cause fainting, seizures, and sudden death. This risk is higher in people with heart disease, electrolyte imbalances like low potassium or magnesium, and in those taking other drugs that affect heart rhythm. Anyone taking thioridazine needed regular ECG monitoring. Tardive dyskinesia is another serious concern with all antipsychotics, including thioridazine. It causes involuntary, repetitive movements of the tongue, lips, face, and sometimes the limbs. These movements can be permanent, and there is no reliable treatment. The risk increases with longer treatment and higher total doses. Neuroleptic malignant syndrome is a rare but life-threatening reaction marked by high fever, muscle rigidity, confusion, and unstable blood pressure. It requires immediate medical attention. Thioridazine can cause a condition called pigmentary retinopathy, where the retina becomes damaged and vision deteriorates. This was more common at higher doses and with long-term use, and it is one reason the drug was withdrawn. Regular eye exams were recommended. The medication also causes significant anticholinergic effects: dry mouth, blurred vision, constipation, urinary retention, and confusion, especially in older adults. It can lower blood pressure when standing up, leading to dizziness and falls. Thioridazine increases prolactin levels, which can cause breast enlargement, milk production in women and men, and menstrual irregularities. It can also cause weight gain and increase blood sugar. People with a history of breast cancer, liver disease, or seizure disorders needed to use thioridazine with caution. It was not recommended during pregnancy unless the benefit clearly outweighed the risk, and it passes into breast milk. Older adults with dementia-related psychosis were at increased risk of death while taking antipsychotics, and thioridazine was not approved for that use.

Contraindications

Thioridazine is contraindicated in patients with severe central nervous system depression or comatose states from any cause. It should not be used in people with hypertensive or hypotensive heart disease of extreme degree, because of the risk of dangerous blood pressure swings and cardiac arrhythmias. It is contraindicated in patients with congenital long QT syndrome or a history of cardiac arrhythmias. Do not use thioridazine in combination with other drugs that are known to prolong the QTc interval. It is also contraindicated with drugs that inhibit CYP2D6, such as fluoxetine, paroxetine, and fluvoxamine, because these can raise thioridazine levels and increase the risk of cardiac toxicity. Thioridazine should not be used in patients with a history of severe allergic reactions to phenothiazines. It is contraindicated in patients with pheochromocytoma, a tumour of the adrenal gland, because it can trigger a hypertensive crisis. The medication should not be used in patients with severe liver disease or blood disorders. It is not recommended for children under 2 years of age. Thioridazine should not be used to treat behavioural problems in older adults with dementia, because of an increased risk of death.

Possible Side Effects

More than 1 in 10 people experienced drowsiness, dizziness, dry mouth, blurred vision, constipation, and weight gain. These effects were often most noticeable when starting treatment or increasing the dose. Some people developed tremor, restlessness, muscle spasms, or a stiff gait, though these extrapyramidal effects were less common with thioridazine than with high-potency antipsychotics. Orthostatic hypotension, a drop in blood pressure when standing up, caused lightheadedness and falls, especially in older adults. The drug also caused nasal congestion, diminished sweating, and urinary retention. Photosensitivity was a concern, so sun protection was advised. Serious side effects required immediate medical attention. Cardiac arrhythmias, including QT prolongation and torsades de pointes, could cause palpitations, fainting, or sudden collapse. Tardive dyskinesia, with involuntary movements of the face and tongue, could develop after months or years of treatment and was sometimes irreversible. Neuroleptic malignant syndrome presented with high fever, severe muscle stiffness, confusion, and autonomic instability. Pigmentary retinopathy caused progressive vision loss, sometimes with brownish discoloration of the retina. Blood disorders, including agranulocytosis, leukopenia, and thrombocytopenia, were rare but serious. Cholestatic jaundice, a liver reaction, caused yellowing of the skin and eyes. Endocrine effects included breast enlargement, galactorrhea, and menstrual irregularities. The medication could also cause a lupus-like syndrome with joint pain and rash. If any of these serious effects occurred, the drug needed to be stopped and medical help sought right away.

Drug Interaction

Thioridazine is metabolized by the liver enzyme CYP2D6. Any drug that inhibits this enzyme can cause thioridazine levels to rise, sometimes to dangerous concentrations. Fluoxetine, paroxetine, and fluvoxamine are strong CYP2D6 inhibitors and were contraindicated with thioridazine. Other antidepressants, including tricyclics and some SSRIs, could also increase levels. Beta-blockers like propranolol inhibited thioridazine metabolism and were contraindicated. Drugs that prolong the QT interval added to the cardiac risk. This list includes many antipsychotics, some antibiotics (like erythromycin and moxifloxacin), antiarrhythmics (like quinidine and amiodarone), and some antihistamines. Thioridazine also potentiated the effects of central nervous system depressants, including alcohol, opioids, and anesthetics, leading to excessive sedation and respiratory depression. Antacids and anti-diarrheal medications could reduce thioridazine absorption. Thioridazine itself inhibited the metabolism of other drugs, including tricyclic antidepressants, phenytoin, and warfarin, which could cause toxicity. It also blocked the antihypertensive effects of guanethidine and similar drugs. Because of the withdrawal from the Canadian market, detailed interaction studies are no longer being updated, but the historical data remain relevant for anyone who still uses this medication in other countries. Tell your doctor and pharmacist about every medication you take, including over-the-counter products and supplements.

Missed Dose

If you miss a dose of thioridazine, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once to make up for a missed one. Taking a double dose can increase the risk of sedation, low blood pressure, and heart rhythm problems. If you miss several doses in a row, contact your doctor before restarting. Abrupt discontinuation after long-term use can cause withdrawal symptoms, including nausea, vomiting, insomnia, and agitation.

Overdose

Thioridazine overdose is dangerous. The drug is toxic in high doses, and cardiac toxicity is the main concern. Symptoms of an overdose include severe drowsiness, confusion, agitation, hallucinations, muscle rigidity, and seizures. The heart can develop dangerous arrhythmias, including QT prolongation and torsades de pointes, which can lead to cardiac arrest. Blood pressure can drop dangerously low. The toxic blood concentration range for thioridazine begins at 1 mg/dL, and 2 to 8 mg/dL is considered the lethal concentration range. If you suspect an overdose, call 911 or go to the nearest emergency department immediately. Do not wait for symptoms to appear. Treatment in a hospital may include activated charcoal, intravenous fluids, medications to control heart rhythm, and close monitoring of vital signs and ECG. There is no specific antidote. Do not try to manage an overdose at home.

Storage

Store thioridazine tablets at room temperature between 20 and 25 degrees Celsius (68 and 77 degrees Fahrenheit). Protect from light. Keep the container tightly closed and store it in a dry place. Do not store in the bathroom or near a sink. Keep out of reach of children and pets. Do not use after the expiry date on the label. Dispose of unused medication according to local guidelines. Do not flush thioridazine down the toilet or pour it down the sink.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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