Zuclopenthixol acetate

Acuphase (Bridge)·Psychiatry - Depot Antipsychotics

Initial treatment of acute psychoses, mania, or exacerbations of chronic psychoses

72H BRIDGEClopixol AcuphaseS4TGA

Max Dose

400 mg / 4 INJECTIONS

Duration

72 HOURS

Sedation

CRITICAL

Acute Mania

INDICATED

Rapid Summary

Overview

The 'Bridge' depot. Formulated in a thin oil that lasts exactly 72 hours. Provides immediate, intense sedation and antipsychotic control for acute mania or psychotic emergencies, buying time for oral meds or long-term depots to kick in.

Maximum Dose

Max 400 mg per course (Max 4 injections total).

Clinical Focus

NOT a long-term depot. Never prescribe this for maintenance. It is an acute chemical restraint/bridge only.

Bottom Line

Zuclopenthixol acetate is a short-acting IM antipsychotic for acute psychosis and severe agitation, but the 72-hour duration means side effects cannot be quickly reversed once administered.

Formulation & Access

Brand Names

Clopixol Acuphase

Parenteral

Ampoules (50 mg/1 mL). Viscous oil.

Prescribing & PBS

Hospital/Psychiatric supply. S4.

Indications & Use

Primary

TGA

Initial treatment of acute psychoses, mania, or exacerbations of chronic psychoses.

Clinical Place

Used in the ED or psychiatric intensive care unit (PICU) when a patient is too violent to take oral meds, and short-acting IM Haloperidol/Droperidol is wearing off too fast.

Quick reference

Class & Role

Acuphase (Bridge) — The 'Bridge' depot.

Route / Formulation

Ampoules (50 mg/1 mL). Viscous oil. (Clopixol Acuphase)

Usual Dose & Max

IM 50-150 mg STAT. May repeat in 2-3 days if necessary. Maximum 4 injections (or 400mg total) per acute episode. Max 400 mg per course (Max 4 injections total).

Key Indication Doses

Acute Psychosis / Mania: IM 50-150 mg STAT. May repeat in 2-3 days if necessary. Maximum 4 injections (or 400mg total) per acute episode. Elderly / Frail: Max 25-50 mg STAT. Extremely sensitive.

Best Uses

Zuclopenthixol acetate is a short-acting IM antipsychotic for acute psychosis and severe agitation, but the 72-hour duration means side effects cannot be quickly reversed once administered.

Avoid / Cautions

Maintenance therapy. Parkinson's disease. Severe CNS depression/intoxication. Pregnancy Category C.

Key Risks

Neurological: Extreme, unavoidable sedation for 2-3 days. HIGH — EPS, dystonia. Cardiovascular: Hypotension, tachycardia. Gastrointestinal: Dry mouth, constipation.

Key Interactions

High-dose Benzodiazepines. Giving Acuphase to a patient already loaded with Midazolam/Diazepam carries a severe risk of respiratory arrest over the next 24 hours.

Monitoring

The patient will likely sleep for 2 days. You MUST monitor their SpO2, RR, and ensure they wake up enough to drink water to prevent severe dehydration and VTE risk from immobility.

Clinical Pearl

Acuphase is the perfect tool for a psychotic patient refusing medications. One injection buys the team exactly 3 days of calm to legally organize treatment orders, establish oral medication regimens, or initiate a 4-weekly depot without fighting the patient every 6 hours for pills.

Access

Clopixol Acuphase

Brand: Clopixol Acuphase

Zuclopenthixol acetate

Acuphase (Bridge)·Psychiatry - Depot Antipsychotics

Initial treatment of acute psychoses, mania, or exacerbations of chronic psychoses

72H BRIDGEClopixol AcuphaseS4TGA

Max Dose

400 mg / 4 INJECTIONS

Duration

72 HOURS

Sedation

CRITICAL

Acute Mania

INDICATED

Rapid Summary

Overview

Maximum Dose

Max 400 mg per course (Max 4 injections total).

Clinical Focus

NOT a long-term depot. Never prescribe this for maintenance. It is an acute chemical restraint/bridge only.

Bottom Line

Zuclopenthixol acetate is a short-acting IM antipsychotic for acute psychosis and severe agitation, but the 72-hour duration means side effects cannot be quickly reversed once administered.

Formulation & Access

Brand Names

Clopixol Acuphase

Parenteral

Ampoules (50 mg/1 mL). Viscous oil.

Prescribing & PBS

Hospital/Psychiatric supply. S4.

Indications & Use

Primary

TGA

Initial treatment of acute psychoses, mania, or exacerbations of chronic psychoses.

Clinical Place

Used in the ED or psychiatric intensive care unit (PICU) when a patient is too violent to take oral meds, and short-acting IM Haloperidol/Droperidol is wearing off too fast.

Quick reference

Class & Role

Acuphase (Bridge) — The 'Bridge' depot.

Route / Formulation

Ampoules (50 mg/1 mL). Viscous oil. (Clopixol Acuphase)

Usual Dose & Max

IM 50-150 mg STAT. May repeat in 2-3 days if necessary. Maximum 4 injections (or 400mg total) per acute episode. Max 400 mg per course (Max 4 injections total).

Key Indication Doses

Acute Psychosis / Mania: IM 50-150 mg STAT. May repeat in 2-3 days if necessary. Maximum 4 injections (or 400mg total) per acute episode. Elderly / Frail: Max 25-50 mg STAT. Extremely sensitive.

Best Uses

Zuclopenthixol acetate is a short-acting IM antipsychotic for acute psychosis and severe agitation, but the 72-hour duration means side effects cannot be quickly reversed once administered.

Avoid / Cautions

Maintenance therapy. Parkinson's disease. Severe CNS depression/intoxication. Pregnancy Category C.

Key Risks

Neurological: Extreme, unavoidable sedation for 2-3 days. HIGH — EPS, dystonia. Cardiovascular: Hypotension, tachycardia. Gastrointestinal: Dry mouth, constipation.

Key Interactions

High-dose Benzodiazepines. Giving Acuphase to a patient already loaded with Midazolam/Diazepam carries a severe risk of respiratory arrest over the next 24 hours.

Monitoring

The patient will likely sleep for 2 days. You MUST monitor their SpO2, RR, and ensure they wake up enough to drink water to prevent severe dehydration and VTE risk from immobility.

Clinical Pearl

Access

Clopixol Acuphase

Brand: Clopixol Acuphase