Anfree® (Flupentixol 0.5 mg + Melitracen 10 mg) - Professional Summary

(Combined anxiolytic & antidepressant)

Indications

Treatment of:

• Anxiety disorders • Depressive episodes (including apathy, psychogenic/masked depression)

• Depressive neuroses • Menopausal depression

• Psychosomatic disorders with anxiety/apathy

• Dysphoria/depression in alcohol/drug dependence
  (Use under registered physician's guidance)

Pharmacology

Dosage & Administration

Adults:

• Initial: 1 tablet AM + 1 tablet noon (max 2 tablets AM in severe cases)

• Maintenance: 1 tablet daily (AM)

Elderly: 1 tablet daily (AM)

Critical Notes:

• Avoid evening dosing (risk of insomnia)

• For acute agitation: Add short-term sedative (not replacement)

• Withdraw prior sedatives gradually
  (Follow registered physician's advice)

Interactions

Contraindications

• Post-MI recovery • Bundle branch block • Untreated narrow-angle glaucoma

• Acute intoxication (alcohol/opioids/barbiturates) • MAOI use within 14 days

• Excitable/overactive patients (may exacerbate symptoms)

Side Effects

Common (>1%):

• Transient restlessness • Insomnia (dose-related)

Rare:

• Anticholinergic effects (dry mouth, constipation - melitracen-related)

• Extrapyramidal symptoms (EPS - flupentixol-related)

Pregnancy & Lactation

• Pregnancy: Avoid (insufficient safety data)

• Lactation: Contraindicated (excretion unknown)

Precautions & Warnings

1. CNS Effects: May cause dizziness/somnolence (caution with driving/machinery)

2. Withdrawal: Taper prior CNS depressants gradually

3. Monitoring Required:

   • Blood glucose (alters levels)

   • Mood changes/suicidal ideation (especially in young adults)

4. Special Populations:

   • Hepatic/renal impairment: Use with caution

   • Cardiac/thyroid/urinary disorders: Requires evaluation

5. Surgery: Disclose use pre-anesthesia (interaction risk)

Overdose Management

Primary Symptoms:

• Anticholinergic crisis (tachycardia, delirium) ± EPS

Treatment Protocol:

1. Gastric lavage + activated charcoal (if <2 hr post-ingestion)

2. Cardiorespiratory support (avoid epinephrine!)

3. Symptom-specific:

   • Seizures → Diazepam IV

   • EPS → Biperiden

4. ICU monitoring for 72+ hours

Therapeutic Class

Combined Anxiolytic and Antidepressant

Storage

• Conditions: ≤30°C • Protect from light/moisture

• Keep out of children's reach