Adult: Initially, 15-30 mg daily in 2 divided doses, with the larger dose given in the evening. Treatment recommendations may vary among individual products and between countries (refer to specific product guidelines). Elderly: Initially, 5-10 mg daily in 2 divided doses, with the larger dose given in the evening; adjust dose according to response. Maintenance: Half or quarter of the adult dose. Dosage and treatment recommendations may vary among individual products and between countries (refer to specific product guidelines).
Oral Psychoses, Schizophrenia
Adult: Initially, 75 mg daily in divided doses, then increase by 25 mg daily at weekly intervals until optimum effect is achieved. Max: 300 mg daily. Dosage and treatment recommendations may vary among individual products and between countries (refer to specific product guidelines). Elderly: Initially, 15-30 mg daily in divided doses. May increase dose if needed according to response. Dosage and treatment recommendations may vary among individual
products and between countries (refer to specific product guidelines). Child: 1-11 years weighing 10 kg Initially, 0.5 mg; increase dose by 1 mg for every additional 5 kg body weight up to 10 mg daily. Doses may be increased gradually based on response. Maintenance dose should not exceed twice the initial dose. 12-17 years Initially, 25 mg tid; increase dose by 25 mg at weekly intervals based on response, up to 100 mg tid. Alternatively, total daily dose may be given in 2 divided doses. Dosage and treatment recommendations may vary among individual
products and between countries (refer to specific product guidelines).
What are the brands available for Periciazine in Hong Kong?
Neulactil
Contraindications
CNS depression, altered states of consciousness or comatose states (particularly when caused by intoxication with CNS depressant medications), history of blood dyscrasias or agranulocytosis, history of liver dysfunction, circulatory collapse, at risk of angle-closure glaucoma, at risk of urinary retention due to urethroprostatic disorders, subcortical brain damage, with or without hypothalamic damage (known or suspected), phaeochromocytoma. Patients receiving spinal or regional anaesthesia. Children <1 year. Contraindications may vary between individual products (refer to specific product guidelines).
Special Precautions
Patient with severe CV disease, risk factors for stroke, familial long QT syndrome, any underlying cardiac abnormality, electrolyte imbalances (e.g. hypokalaemia, hypocalcaemia, or hypomagnesaemia), decreased gastrointestinal motility, paralytic ileus, benign prostatic hyperplasia; subjected to dehydration, strenuous exercise, or heat exposure; risk factors for thrombosis, or at risk of seizures (e.g. history of seizures, head trauma, alcoholism, concurrent treatment with medications which may lower seizure threshold), Parkinson’s disease, Lewy body dementia; hypothyroidism, diabetes, breast cancer or other prolactin-dependent tumours, myasthenia gravis, severe respiratory disease, photosensitisation. Patients at risk of developing thrombocytopenia (e.g. family history of thrombocytopenia or other blood disorders); at risk for aspiration pneumonia (e.g. Alzheimer's disease); at risk of orthostatic hypotension or in those who would not tolerate transient hypotensive episodes (e.g. cerebrovascular disease, hypovolaemia). Avoid abrupt withdrawal. Not approved for use in older patients with dementia. Avoid use in patients with untreated seizure disorders. Renal and severe hepatic impairment. Children ≥1 year and elderly. Pregnancy and lactation.
Adverse Reactions
Significant: Extrapyramidal symptoms (e.g. acute dystonic reactions, akathisia, pseudoparkinsonism, tardive dyskinesia), NMS, falls, CNS depression, orthostatic hypotension, anticholinergic effects (e.g. xerostomia, constipation, blurred vision, urinary retention), hypersensitivity reactions (e.g. angioedema, urticaria), abnormal skin pigmentation (prolonged use), impaired core body temperature regulation, retinal changes, hyperprolactinaemia, erectile dysfunction (including priapism), gynaecomastia, changes in libido, menstrual disorders, delayed ovulation, inhibition of ejaculation, weight gain, glucose intolerance or hyperglycaemia, photosensitivity, blood dyscrasias (e.g. agranulocytosis, eosinophilia, granulocytopenia, neutropenia, and thrombocytopenia), oesophageal dysmotility, aspiration. Rarely, QT prolongation, jaundice and liver damage (cholestatic or mixed type). Blood and lymphatic system disorders: Leucopenia. Cardiac disorders: Atrial arrhythmia, AV block. Eye disorders: Abnormal pigmentation including deposits in the anterior segment of the eye; accommodation disorder, corneal deposits, exacerbation of glaucoma. Gastrointestinal disorders: Vomiting, nausea, faecal impaction, diarrhoea, paralytic ileus. General disorders and administration site conditions: Oedema. Investigations: ECG changes including ST depression, changes in U-waves and T-waves. Metabolism and nutrition disorders: Increased appetite. Nervous system disorders: Sedation, somnolence, seizure. Psychiatric disorders: Indifference, confusional state, delirium, anxiety, mood changes, agitation, insomnia, aggressive behaviour, paradoxical psychosis. Reproductive system and breast disorders: Galactorrhoea, amenorrhoea. Respiratory, thoracic and mediastinal disorders: Nasal congestion, hypostatic pneumonia, respiratory depression. Skin and subcutaneous tissue disorders: Diaphoresis, rash. Potentially Fatal: Ventricular arrhythmias (e.g. torsade de pointes), VTE (including pulmonary embolism).
Patient Counseling Information
This drug may cause drowsiness, dizziness, and blurred vision, if affected, do not drive or operate machinery. Avoid direct exposure to sunlight.
Monitoring Parameters
Monitor adherence, mental status and alertness. Perform ocular exam as clinically indicated. Evaluate for history of metabolic syndrome. Monitor vital signs (e.g. blood pressure, temperature, pulse rate), fall risk (particularly in elderly), CBC, electrolytes, renal function, liver function, and TSH as clinically indicated; fasting plasma glucose/HbA1c and lipid panel (4 months after treatment initiation and annually); prolactin levels (if symptoms of hyperprolactinaemia are reported); weight, height, and BMI (every visit for the 1st 6 months then quarterly) and waist circumference (at baseline and annually). Assess for signs of symptoms of extrapyramidal reactions, tardive dyskinesia, and hyperprolactinaemia.
Overdosage
Symptoms: Neuroleptic overdose may manifest as drowsiness, loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmias, hypothermia, severe extrapyramidal dyskinesias; lethargy, dysarthria, ataxia, stupor, reduced consciousness progressing to coma with areflexia, as well as convulsions and mydriasis. Patients with early or mild intoxication may present with restlessness, confusion, agitation, excitement or delirious state. Other symptoms include CV symptoms related to risk of QT prolongation (e.g. hypotension, ventricular tachycardia and arrhythmias); respiratory depression, pupillary constriction or dilation tremor, muscle twitching, spasm or rigidity, difficulty in swallowing or breathing, CV collapse, cyanosis, respiratory and/or vasomotor collapse, possibly with sudden apnoea; polyuria (which may lead to dehydration), anticholinergic syndrome, severe parkinsonian syndrome.
Management: Symptomatic and supportive treatment. Perform gastric lavage or aspiration. May give activated charcoal. Ensure airway maintenance in cases of pronounced CNS depression, with assisted respiration provided if the condition is severe. Elevate the patient's legs if generalised vasodilatation occurs; in severe cases, IV fluid volume expansion may be required. Warm the infusion fluids prior to administration to avoid worsening hypothermia. May administer positive inotropic agents (e.g. dopamine) if fluid replacement is insufficient to correct circulatory collapse. Peripheral vasoconstrictor agents are generally not recommended; avoid the use of epinephrine. In case of persistent life-threatening ventricular or supraventricular tachyarrhythmias, may consider appropriate antiarrhythmic therapy. Procyclidine (5-10 mg) or orphenadrine (20-40 mg) may be administered intramuscularly or intravenously for severe dystonic reactions. In case of convulsions, IV diazepam may be given. Manage NMS with cooling and consider dantrolene sodium if necessary.
Drug Interactions
Increased risk of ventricular arrhythmias with sultopride. Increased risk of arrhythmias when used concomitantly with QT-prolonging drugs (e.g. certain anti-arrhythmics, antidepressants, other antipsychotics) and drugs causing electrolyte imbalance. Enhanced CNS depressant effect with barbiturates, benzodiazepines, and other sedatives. May result in reciprocal antagonism with dopaminergic antiparkinsonian agents (e.g. levodopa). May inhibit the antihypertensive effect of guanethidine. Decreased absorption with antacids. May increase the hypotensive effects of antihypertensive agents (e.g. α-adrenoceptor blocking agents). May increase or decrease the serum concentrations of propranolol and phenobarbital. May increase neurotoxic effects with lithium. Increased risk of agranulocytosis with myelosuppressive agents (e.g. carbamazepine). May increase serum concentrations of amitriptyline. May induce transient metabolic encephalopathy with deferoxamine and prochlorperazine. Increased photosensitivity with photosensitising agents.
Food Interaction
Enhanced CNS depressant effect with alcohol.
Lab Interference
May cause a false-positive pregnancy test result.
Action
Description: Overview: Periciazine is a phenothiazine of the piperidine group with sedative and antipsychotic properties. Mechanism of Action: Periciazine blocks subcortical dopamine receptors in the brain and depresses the release of hypothalamic and hypophyseal hormones. In addition, it has adrenolytic, anticholinergic, and extrapyramidal effects. Synonym(s): Pericyazine.
Chemical Structure
Periciazine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4747, Periciazine. https://pubchem.ncbi.nlm.nih.gov/compound/Periciazine. Accessed Feb. 25, 2026.
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