Largo Uses

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What is Largo?

Largo is an anti-psychotic medication in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in your brain.

Largo is used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children ages 1 through 12.

Largo is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus.

Largo may also be used for purposes not listed in this medication guide.

Largo indications

infoAn indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Largo is a phenothiazine neuroleptic and is indicated in the following conditions:

1) Psychotic conditions (especially paranoid), including schizophrenia, mania and hypomania.

2) As an adjunct in the short-term management of anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour.

3) Nausea or vomiting associated with terminal illness, where other agents are ineffective or unavailable.

4) Intractable hiccup.

5) Childhood schizophrenia and autism.

How should I use Largo?

Use Largo as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Largo is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Largo at home, a health care provider will teach you how to use it. Be sure you understand how to use Largo. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use Largo if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Largo may irritate skin. Avoid contact with skin or clothing. Wear rubber gloves while using Largo.
  • Do not suddenly stop taking Largo.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of Largo and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Largo.

Uses of Largo in details

infoThere are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Largo is used for the treatment of schizophrenia (a long-term mental disorder often characterized by abnormal social behaviour and failure to recognize what is real), and other psychosis (in which some or all symptoms of schizophrenia may be present), particularly paranoia (misbeliefs and feelings of harassment), mania [overactive behaviour and hypomania (elated moods and excitability)], anxiety, agitation and violent or dangerously impulsive behaviour. Largo is also used for prolonged periods of hiccups, nausea and vomiting (when other drugs have failed), to lower body temperature in childhood schizophrenia and autism (learning and communication difficulties).

Largo description

A carbamate with hypnotic, sedative, and some muscle relaxant properties, although in therapeutic doses reduction of anxiety rather than a direct effect may be responsible for muscle relaxation. Largo has been reported to have anticonvulsant actions against petit mal seizures, but not against grand mal seizures (which may be exacerbated). It is used in the treatment of anxiety disorders, and also for the short-term management of insomnia but has largely been superseded by the benzodiazepines. (From Martindale, The Extra Pharmacopoeia, 30th ed, p603) Largo is a controlled substance in the U.S.

Largo dosage

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Adult Initially 25-50 mg tid, increased if necessary. Doses of 75 mg may be given as single dose at night.

Maintenance: 25-100 mg tid. Psychotic patient Up to ≥1 g. Nausea & vomiting 10-25 mg every 4-6 hr. Elderly & debilitated patient 1/3-1/2 the adult dose. Childn >5 yr (w/ psychiatric conditions) 1/3-1/2 the adult dose, 1-5 yr 500 mcg/kg every 4-6 hr. Max: 75 mg daily (for childn >5 yr) or 40 mg daily (for childn 1-5 yr).

Largo interactions

See also:
What other drugs will affect Largo?

Alcohol, barbiturates and other sedatives may intensify the CNS depressant effects of Largo and respiratory depression may occur.

The hypotensive effect of most antihypertensive agents, especially alpha-adrenoceptor blocking agents, may be exaggerated by Largo.

Largo has mild anticholinergic activity which may be enhanced by other anticholinergic drugs.

Anticholinergic drugs may decrease the antipsychotic effect of Largo. Largo may oppose the action of some drugs, including amphetamine, levodopa, adrenaline, clonidine and guanethidine.

Some drugs interfere with the absorption of neuroleptic agents, e.g. antacids, lithium, anti-Parkinsonian agents. Although increases or decreases have been observed in the plasma concentrations of a number of drugs, including propranolol and phenobarbitone, these were not of clinical significance.

At high dosage, Largo reduces the response to hypoglycaemic agents, which may require an increase in dosage of the latter.

Clinically significant adverse drug interactions with alcohol, guanethidine and hypoglycaemic agents are documented. Adrenaline must not be used in cases of overdosage with Largo. Other interactions are of theoretical interest and are not of a serious nature. Concomitant administration of desferrioxamine and prochlorperazine has been reported to cause a transient metabolic encephalopathy with loss of consciousness for 48 to 72 hours. The possibility of a similar occurrence with Largo exists, because it shares many of the pharmacological activities of prochlorperazine.

Largo side effects

See also:
What are the possible side effects of Largo?

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Minor side effects include nasal stuffiness, dry mouth, insomnia and agitation.

Cardiovascular: Hypotension, especially postural, is relatively common and elderly patients or subjects with volume depletion are particularly susceptible. Cardiac arrhythmias have been reported in patients receiving neuroleptic agents and may be dose-related. They include atrial arrhythmia, A-V block, ventricular tachycardia and fibrillation. Pre-existing cardiac disease, hypokalaemia, concurrent use of tricyclic antidepressants and old age may predispose to development of arrhythmia. E.C.G. changes may occur, including widened QT interval, ST depression, U waves and T wave changes.

Blood: Mild leucopenia may occur in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely and is not dose-related. Unexplained infections or pyrexia require immediate haematological investigations.

Respiratory: Clinical doses of the neuroleptics usually have little effect on respiration. However, respiratory depression may occur in susceptible patients.

Hepatic: A very small percentage of patients may develop jaundice, which is usually transient and which may be preceded by sudden pyrexia after one to three weeks of treatment. The jaundice is obstructive in type and is frequently accompanied by an eosinophilia, indicating the allergic nature of the event. Largo therapy should be withdrawn if jaundice occurs.

Extrapyramidal: Acute dystonic or dyskinetic reactions may occur. These are usually transitory, are commoner in children and young adults and are more likely to occur within the first four days of treatment or after dosage increases. Akathisia may occur, characteristically following large initial doses.

Neuroleptic - induced parkinsonism is commoner in adults and the elderly and usually takes weeks or months of treatment to develop. Tremor is a common sign but rigidity, akinesia or other features of parkinsonism may also occur.

If tardive dyskinesia occurs, it is usually although not always associated with prolonged or high dosage. It may occur after treatment has been discontinued. To reduce the likelihood of tardive dyskinesia, the dosage should be kept low whenever possible.

Skin and Eyes: Various skin rashes may occur during therapy with Largo. Photosensitivity eruptions may occur and patients receiving high dosage should be advised to avoid exposure to direct sunlight. Contact skin sensitisation is a rare but serious complication in persons who frequently handle Largo preparations and particular care should be taken to avoid contact of the drug with the skin.

Ocular changes and a metallic greyish-mauve discolouration of exposed skin have been reported in some patients, mainly females, who received Largo continuously for long periods of between four and eight years.

Endocrine: Hyperprolactinaemia has been reported and may result in galactorrhoea, gynaecomastia or amenorrhoea; impotence has been reported.

Neuroleptic malignant syndrome: The syndrome may occur with use of any neuroleptic agent. Symptoms include clouding of consciousness, rigidity and other extrapyramidal effects, and autonomic dysfunction, most importantly hyperpyrexia. Treatment involves the immediate cessation of neuroleptic therapy and symptomatic management as appropriate.

Cases of venous thromboembolism, including cases of pulmonary embolism and cases of deep vein thrombosis have been reported with antipsychotic drugs- Frequency unknown

Largo contraindications

See also:
What is the most important information I should know about Largo?

Largo is contraindicated in patients with a known hypersensitivity to the drug. Largo is also contraindicated in comatose patients, including those under the influence of alcohol or other central nervous system depressants.

Active ingredient matches for Largo:

Chlorpromazine HCl in Singapore.

Chlorpromazine hydrochloride in Singapore.


Unit description / dosage (Manufacturer)Price, USD
Largo 25 mg x 1000's
Largo 100 mg x 1000's

List of Largo substitutes (brand and generic names):

Chlorpromazine Hydrochloride tablet, sugar coated 25 mg/1 (Mylan Institutional Inc. (US))
Chlorpromazine Hydrochloride tablet, sugar coated 200 mg/1 (Clinical Solutions Wholesale (US))
Chlorpromazine Hydrochloride tablet, sugar coated 10 mg/1 (Upsher Smith Laboratories, Inc. (US))
Chlorpromazine Hydrochloride tablet, film coated 25 mg/1 (Physicians Total Care, Inc. (US))
Chlorpromazine Hydrochloride tablet 200 mg/1 (REMEDYREPACK INC. (US))
Chlorpromazine Hydrochloride tablet 50 mg/1 (REMEDYREPACK INC. (US))
Clorpromazin 25 mg x 1 Bottle 500 Tablet
Clorpromazin 25 mg x 1 Bottle 1200 Tablet
Clorpromazin 100 mg x 1 Bottle 400 Tablet
Clorpromazin 100 mg x 1 Bottle 1000 Tablet
25 mg x 10's (La Pharma)$ 0.04
50 mg x 10's (La Pharma)$ 0.06
100 mg x 10's (La Pharma)$ 0.10
200 mg x 10's (La Pharma)$ 0.15
Emetil 25mg TAB / 10 (La Pharma)$ 0.04
Emetil 50m TAB / 10 (La Pharma)$ 0.06
Emetil 100mg TAB / 10 (La Pharma)$ 0.10
Emetil 200mg TAB / 10 (La Pharma)$ 0.15
EMETIL 100 MG TABLET 1 strip / 10 tablets each (La Pharma)$ 0.12
EMETIL 25 MG TABLET 1 strip / 10 tablets each (La Pharma)$ 0.05
EMETIL 50 MG TABLET 1 strip / 10 tablets each (La Pharma)$ 0.07
EMETIL tab 25 mg x 10's (La Pharma)$ 0.04
EMETIL tab 50 mg x 10's (La Pharma)$ 0.07
EMETIL tab 100 mg x 10's (La Pharma)$ 0.11
EMETIL tab 200 mg x 10's (La Pharma)$ 0.15
Emetil 25mg TAB / 10 (La Pharma)$ 0.04
Emetil 50m TAB / 10 (La Pharma)$ 0.06
Emetil 100mg TAB / 10 (La Pharma)$ 0.10
Emetil 200mg TAB / 10 (La Pharma)$ 0.15
Emetil 100mg Tablet (La Pharma)$ 0.01
Emetil 25mg Tablet (La Pharma)$ 0.00
Emetil 50mg Tablet (La Pharma)$ 0.01
Hatomazin 12.5 mg/2 mL x 2 mL
Hatomazin 12.5 mg/2 mL x 5 mL
Largactil 100 liquid 100 mg (Sanofi Aventis Canada Inc (Canada))
Zycloran tab 100 mg 100's (China Yanzhou)
Zycloran tab 200 mg 100's (China Yanzhou)

References

  1. DailyMed. "CHLORPROMAZINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "chlorpromazine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "chlorpromazine". http://www.drugbank.ca/drugs/DB00477 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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