Modecate (fluphenazine)

Modecate (fluphenazine)

Brand name: Modecate®
Active ingredient name: Fluphenazine
Type of drug: Typical antipsychotic
Form: Oral tablets, injection
Brand name available in Canada from: Bristol-Myers Squibb Canada
Generic: Yes: Apo-Fluphenazine Tab, Apo-Fluphenazine Injectable (Apotex Inc.); Fluphenazine Omega (Omega Laboratories Inc.); PMS-Fluphenazine Tab, PMS-Fluphenazine Decanoate (Pharmascience Inc.)
Listed on Ontario formulary: Yes
This medication will be discontinued by December 2018. 

What is Modecate used for?

Modecate is used to treat symptoms of schizophrenia and other psychotic illnesses.  It may be used to treat other illnesses.  Discuss with your doctor why you are using Modecate. 

How Should I take Modecate?

Modecate can be taken with or without food. It is most often taken 2-3 times per day but in some cases may be given once daily. 

How much Modecate should I take?

Modecate is available in 1, 2, 2.5, and 5 mg tablets. Long-acting Modecate is available in concentrations of 25 and 100 mg/mL.
The usual dose range for oral modecate is 5-40 mg per day.  Discuss your individual dose with your doctor.
If you are taking the long-acting Modecate depot the usual starting dose is 12.5 mg  The usual maintenance dose is 25-50 mg every 2-4 weeks.  Some doses may be up to 100 mg every 2-4 weeks.  Discuss your individual dose with your doctor.  

What are the common side effects seen with Modecate? 

The most common side effects of Modecate include:
  • Abnormal movements (extrapyramidal symptoms)
  • Changes in monthly menstrual cycle (amenorrhea)
  • Decreased sexual interest and/or function
  • Swelling of breasts and milk production in males and females
  • Sleeplessness/sleepiness
  • Dizziness
  • Headache
  • Constipation
  • Dryness of the mouth
  • Nausea
  • Weight change
  • Blurred vision

What are rare but potentially serious adverse effects with Modecate?

  • Decrease in white blood cell count (agranulocytosis)
  • Neuroleptic Malignant Syndrome (NMS)
  • Sudden cardiac death (heart attack)
  • Torsades de pointes (serious heart arrhythmia) 


Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics.  Most deaths appear to be either cardiovascular or infectious.  Modecate is not approved for the treatment of dementia-related psychosis.  Some individuals with dementia may however be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication. 

What medications interact with Modecate?

Tell all your doctors, pharmacists, and dentist that you are taking Modecate. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription and herbal and vitamin products. 

The following types of medications may interact with Modecate:

  • Certain medications for  allergies (e.g., Benadryl [diphenhydramine])
  • Certain medications for sleep (e.g., lorazepam, zopiclone)
  • Certain medications for pain (e.g., fentanyl)
  • Certain medications for seizures (e.g., Carbamazepine)
  • Antiparkinson medications 
Avoid drinking alcohol or using illegal drugs while taking Modecate.