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This medication carries several important safety warnings and precautions that require careful consideration. Below is a summary of key risks and instructions:

• Risk of Serious Heart Rhythm Problems (QT Prolongation): Thioridazine has been associated with rare but potentially life-threatening irregular heartbeats. It should only be used when other antipsychotics are ineffective or not tolerated. Avoid using it with other medications that may cause heart rhythm issues. Increased caution is advised for patients with a history of heart problems, slow heart rate, or low potassium or magnesium levels.

• Increased Mortality in Elderly with Dementia: Older adults with dementia-related psychosis may face a higher risk of fatal outcomes, such as heart failure or infections, when using antipsychotic medications like thioridazine. This medication is not approved for treating dementia-related behavioral problems.

• Uncontrolled Body Movements (Tardive Dyskinesia): Prolonged use of thioridazine can lead to involuntary body movements, which may become permanent. The risk is higher with long-term or high-dose use, particularly in older adults and females. Immediate consultation with a healthcare provider is advised if such symptoms occur.

• Neuroleptic Malignant Syndrome (NMS): This rare but serious condition can occur with antipsychotic use, characterized by high fever, muscle stiffness, confusion, and irregular heartbeat. Urgent medical attention is essential if these symptoms arise.

• Risk of Falls: Thioridazine may cause dizziness and drop in blood pressure, increasing the likelihood of falls. Patients should rise slowly from seated or lying positions and steady themselves.

• Reduced White Blood Cell Count: While uncommon, thioridazine can lower white blood cell levels, heightening infection risk. This is particularly concerning for those with pre-existing low blood cell counts.

• Elevated Prolactin Levels: Prolonged use can raise prolactin hormone levels, potentially causing menstrual changes, sexual issues, or breast changes. Discuss any concerns with your healthcare provider.

• Pregnancy Concerns: Thioridazine should only be used during pregnancy if benefits outweigh risks due to potential harm to the unborn baby and withdrawal symptoms in newborns. Notify your medical team if you are pregnant or plan to become pregnant.

Contraindications:

• Do not use thioridazine if you are taking other QT-prolonging drugs, have certain heart arrhythmias, or are taking medications that interfere with thioridazine's metabolism (e.g., fluoxetine, paroxetine).
• Avoid use if you have CYP2D6 enzyme deficiencies, are in a coma, or have heart issues due to extreme blood pressure levels.

Consult your healthcare provider for a full discussion of risks and benefits before starting thioridazine.

Common side effects:

• dizziness
• lightheadedness
• drowsiness
• blurred vision
• dry mouth
• constipation

Less common but important to monitor:

• nausea
• vomiting
• diarrhea
• headaches
• restlessness
• tiredness
• changes in vision
• difficulty urinating
• nighttime confusion
• sensitivity to light
• skin reactions like hives

Serious side effects:

• severe dizziness
• fainting
• slow heartbeat
• seizures
• abnormal heart rhythms
• involuntary muscle movements
• neuroleptic malignant syndrome
• tardive dyskinesia
• increased prolactin levels
• severe allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• Cabergoline
• Lithium
• Amiodarone
• Dofetilide
• Pimozide
• procainamide
• quinidine
• Sotalol
• Erythromycin

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• bupropion
• Cinacalcet
• Duloxetine
• mirabegron
• Propranolol
• rolapitant
• terbinafine
• Fluoxetine
• Fluvoxamine
• paroxetine
• elacestrant
• lonafarnib
• mavacamten
• codeine
• hydrocodone
• Alprazolam
• Lorazepam
• Cyclobenzaprine
• Cetirizine
• diphenhydramine