Zuclopenthixol is used to treat and prevent the return of symptoms in Schizophrenia and other mental health related conditions. Learn how to use the medication, its common side effects, special precautions to watch out for, and more.

What is this medication for?

Zuclopenthixol depot Injection belongs to a class of medications known as typical (first-generation) antipsychotics. It is used to treat and prevent the return of symptoms in Schizophrenia and other mental health related conditions such as:

• Hearing, seeing or sensing things that are not real
• Having mistaken beliefs
• Uncontrolled anger
• Being overly suspicious

A depot injection is a special preparation of medication which is given in the form of an injection into the upper arm, thigh or buttocks. The medication is then slowly released and absorbed to the rest of the body over a number of weeks.

Zuclopenthixol depot Injection may also be used for other conditions. Check with your healthcare professional if you are unsure why you are given this medication.

How should I take/use this medication?

• A small dose of the medication, called a test dose, will usually be given when you are started on this medication to help avoid any prolonged and severe side effects.
• If you have no side effects from the test dose, you may be given an additional dose, called a top-up dose, a few days or up to a week after the test dose.
• Subsequent injections will be given at regular intervals. The interval between each injection will be decided by your doctor (e.g. every 2 to 4 weeks).
• It is important for you to be regular with your scheduled depot injections at the clinic. Missing your injections for too long a time (e.g. several weeks or months) may result in a recurrence of your previous symptoms.

What should I do if I forget to take/use this medication?

If you have missed an injection, please call up your doctor to arrange for an appointment visit.

What precautions should I take?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side effects with you and should you have further questions or concerns, do consult your doctor.
• You are taking any other medications (including those that can be bought without a prescription), supplements, traditional Chinese medicine and herbal products. Some of them may affect how this medication works or cause serious drug interactions.
• You have or have ever had:
  • Other drug allergies
  • Medical conditions such as:
    • Kidney or liver disease, irregular heartbeat or other heart problems, glaucoma (high pressure in the eye), urinary or prostate problems, stroke, pheochromocytoma (tumour of the adrenal glands), sleep apnea (a condition where breathing repeatedly starts and stops during sleep) 
    • Parkinson’s disease, dementia, seizure (fits), high or low blood pressure, blood disorders, diabetes, history of blood clots

Zuclopenthixol depot injection can make your skin more sensitive to sunlight. Avoid prolonged exposure to sunlight. Wear protective clothing or use sunscreen if necessary.

What are some common side-effects of this medication?

The mentioned side effects generally affect up to 10% of patients.

• Constipation 
  • Drink more water (if you do not have any fluid restriction), eat more high-fibre foods, and exercise regularly
  • Speak to your doctor or pharmacist if you need medication to help with your constipation
• Dizziness
  • Get up slowly from a sitting or lying down position
• Drowsiness or feeling tired
  • Avoid driving or taking part in activities that require concentration
  • Discuss with your doctor if you can take your medication at a different time of the day
• Difficulty sleeping
  • Discuss with your doctor if you can take your medication at a different time of the day
  • Listen to relaxing music at bedtime
  • Avoid eating or drinking too much before bedtime
  • Limit your caffeine intake (such as coffee, tea or energy drinks) at least 8 hours before bedtime
• Increase in appetite, weight gain
  •  Exercise regularly and eat a healthy and balanced diet
• Dry mouth
  • Chew sugar-free gum, suck on sugar-free hard candies or ice chips, sip water regularly
• Muscle movement side effects (extrapyramidal side effects) – do speak to your doctor for further management. Examples include:
  • Muscle stiffness and spasms (such as in the face, neck and back), difficulty in speaking or swallowing, twitching, or upward rolling of eyes (symptoms of dystonia)
  • Restlessness or need to keep moving constantly (akathisia)
  • Uncontrollable shaking of limbs (tremors)
• Pain at injection site

Most of the side effects listed here will improve with time. Speak with your doctor if any of them continues, worsens or affects your daily life.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Rarely this medication may cause:

• Confusion, high fever, severe muscle stiffness, irregular blood pressure (signs and symptoms of neuroleptic malignant syndrome)
• Uncontrollable movements (such as in the face, tongue, jaw or other parts of the body (tardive dyskinesia))
• Sudden weakness or numbness in the face, arms or legs, and speech or vision problems (signs and symptoms of stroke)
• Loss of appetite, severe nausea or vomiting, pain in the upper part of the stomach, yellowing of the skin or ‘whites’ of the eyes, dark-brown coloured urine and/or pale/clay-coloured stools (signs and symptoms of a liver problem)
• Seizures (fits)
• Problems with eyesight or blurred vision
• Difficulty in passing urine (urinary retention)
• Fast or irregular heartbeat, fainting episodes (signs and symptoms of an abnormal heart beating rhythm (prolonged QTc interval))
• Fever, chills, sore throat and/or mouth ulcers that do not go away (symptoms of blood dyscrasias)
• Severe chest pain, difficulty breathing, or severe pain or swelling in either of the legs (symptoms of venous thromboembolism)
• Increased prolactin hormone in the body (hyperprolactinemia):
  • Changes in menstrual cycle in females (irregular or stopping of menstrual periods) and/or
  • Abnormal breast swelling, soreness or secretion (in both men and women)

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take this medication?

Avoid drinking alcohol while taking Zuclopenthixol depot Injection as it can cause excessive sleepiness.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

If used at home, you may throw this injection away along with the used needles, into a metal tin, or glass jar or thick plastic container (e.g. detergent bottles) before throwing into the rubbish chute or bin to prevent any needle stick injury.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Aug 2023