Triflupromazine (Vesprin): Why This Phenothiazine Left U.S. Pharmacies and What Telehealth Can Still Do

Last updated: August 24, 2026

Triflupromazine is a phenothiazine antipsychotic and antiemetic. U.S. pharmacies sold it as Vesprin (triflupromazine hydrochloride). Clinicians used it for psychosis and for nausea. It is not a current U.S. retail product. NCATS Inxight Drugs lists triflupromazine and the hydrochloride salt as previously marketed, with first approval in 1957, and states that the drug was discontinued. A licensed telehealth clinician can still evaluate psychosis, anxiety, and related mood symptoms and discuss medicines that U.S. pharmacies actually stock. This page is education. It is not a prescription and it is not a promise that any clinician will start or restart triflupromazine.

This guide is educational. It is not a diagnosis.

Looking for mental health care online? Klarity Health has 2,000+ licensed providers. Many visits happen by video. Coverage varies by plan. Self-pay is also an option. See online anxiety treatment options or browse conditions.

TLDR

• Triflupromazine is a phenothiazine. DrugBank DB00508 describes it as an antipsychotic and an antiemetic.
• NCATS Inxight Drugs (UNII RO16TQF95Y): triflupromazine free base; first approved 1957; status US Previously Marketed; brand Vesprin; condition psychosis. The salt record is triflupromazine hydrochloride (UNII 9E75N4A5HM).
• NCATS mechanism: binds dopamine D1 and D2 receptors and inhibits their activity; also binds muscarinic acetylcholine receptors M1 and M2. The description states the product was discontinued.
• NCATS dose table (historic, not a live label): recommended intramuscular 150 mg once daily (multiple); recommended intravenous 3 mg once daily (multiple); oral 800 mg once daily listed as overdose.
• No current DailyMed monograph for triflupromazine exists. Phenothiazines as a class still carry the boxed dementia-related mortality warning that appears on remaining first-generation products such as chlorpromazine and fluphenazine.
• LiverTox (NBK548793) documents cholestatic liver injury for chlorpromazine, the prototype phenothiazine. Treat triflupromazine as the same chemical family for liver caution.
• Not a controlled substance historically. Telehealth can review psychosis history and discuss available antipsychotics. A U.S. clinician cannot fill Vesprin from a community pharmacy. Fever with stiff muscles, chest pain, fainting, or suspected overdose need emergency care. If you are in crisis, call or text 988.

Table of contents

• What triflupromazine is
• How it works
• Historic uses
• Historic dosing
• Side effects and class risks
• Warnings
• When telehealth is enough
• How a Klarity visit fits
• FAQ

What triflupromazine is

Triflupromazine is a phenothiazine with a trifluoromethyl group on the ring system. DrugBank classifies it as a small molecule (DB00508) used as an antipsychotic and an antiemetic. NCATS lists the free base as C18H19F3N2S, molecular weight 352.417, UNII RO16TQF95Y, InChIKey XSCGXQMFYRHWUKG-UHFFFAOYSA-N. The marketed salt was triflupromazine hydrochloride, C18H19F3N2S.ClH, molecular weight 388.878, UNII 9E75N4A5HM.

NCATS marks both records as previously marketed in the United States, first approved in 1957, brand Vesprin, condition psychosis. You will not find a current U.S. brand or generic on pharmacy shelves. Related Klarity first-generation guides: acetophenazine (Tindal), promazine (Sparine), mesoridazine (Serentil), and haloperidol (Haldol).

How it works

NCATS says triflupromazine binds dopamine D1 and D2 receptors and inhibits their activity. It also binds muscarinic acetylcholine receptors M1 and M2. That mix of dopamine blockade and anticholinergic activity is typical of older phenothiazines and helps explain both antipsychotic effects and side effects such as dry mouth, constipation, and blurred vision.

DrugBank’s public card is brief: a phenothiazine used as an antipsychotic agent and as an antiemetic. Absorption, half-life, and clearance fields on the public card are not fully populated. Do not treat research papers that mention triflupromazine as a live prescribing label.

Historic uses

NCATS lists psychosis as the approved condition and Vesprin as the product name. The same record describes the drug as an antipsychotic and an antiemetic used in the management of psychoses, then states that it was discontinued.

PubChem CID 5568 notes use particularly to control violent behavior during psychotic episodes in older literature summaries. A Wiley chemistry review (October 14, 2025) states approval as a drug in 1957 and former brand Vesprin. That is a chemistry review, not a prescribing label. Triflupromazine is not FDA-approved today for dementia-related psychosis, bipolar maintenance, or anxiety as a first-line home medicine.

Your clinician matches any current antipsychotic to your history. This article is education, not a personal prescription plan.

Want care that is actually available in 2026? Browse Klarity condition pages or see online anxiety treatment options. Coverage varies by plan. Verify benefits before you book.

Historic dosing

There is no live FDA label to quote. NCATS publishes a historic dose table on both the free-base and hydrochloride records:

• Intramuscular (listed as recommended): 150 mg once daily, multiple, unhealthy population.
• Intravenous (listed as recommended): 3 mg once daily, multiple, unhealthy population.
• Oral (listed as overdose): 800 mg once daily, multiple, unhealthy population.

The in-vivo sample use guide on the NCATS hydrochloride card is marked unknown. Route of administration on that card is intramuscular. Do not use those numbers to self-dose leftover tablets or injectables from another country. A U.S. clinician who sees you by video will talk about medicines they can actually prescribe and monitor.

Side effects and class risks

Public DrugBank and NCATS cards do not publish a complete adverse-event table for triflupromazine. Phenothiazine class effects still apply. On remaining labels (chlorpromazine, fluphenazine, perphenazine), those include drowsiness, dizziness, dry mouth, constipation, blurred vision, orthostatic blood-pressure drops, extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, blood dyscrasias, photosensitivity, and heat intolerance.

LiverTox’s chlorpromazine chapter is the best public liver reference for this chemical family. It reports liver-test abnormalities in up to 40% of people on long-term chlorpromazine, usually mild and self-limited, plus a well-known cholestatic injury pattern. Treat unexplained jaundice, dark urine, or right-upper-quadrant pain as a reason to stop a phenothiazine and get labs, even if the specific drug is historic.

Warnings

Older adults with dementia-related psychosis treated with antipsychotics have a higher risk of death. That boxed warning is on every remaining first-generation antipsychotic label. Triflupromazine is not approved for dementia-related psychosis.

Class contraindications on related phenothiazine labels typically include coma or severe CNS depression, blood dyscrasias, significant liver damage, and hypersensitivity to phenothiazines. Mesoridazine (Serentil) left the U.S. market in part because of QT prolongation. Triflupromazine does not have a published QT study of that size on the NCATS card, but any phenothiazine plus other QT-prolonging drugs deserves a cautious clinician review.

Insurance coverage for a replacement antipsychotic may vary by plan. Patients should verify benefits before booking. Klarity does not promise that any plan will cover a specific medicine.

When telehealth is enough

Telehealth.HHS.gov policy updates (last updated February 5, 2026) state that Medicare patients can permanently receive behavioral and mental health telehealth in the home, with no geographic originating-site restriction, and that audio-only is permanently allowed for those Medicare behavioral services. An in-person visit within six months of an initial Medicare behavioral telehealth service is not required through December 31, 2027.

What video care can do: take a full history, review past antipsychotics, screen for EPS and tardive movements on camera, discuss metabolic labs, and prescribe a currently marketed oral antipsychotic when appropriate. What video care cannot do: dispense Vesprin, give depot injections, or treat NMS, acute dystonia with airway risk, or suspected overdose. Those need a clinic or emergency department.

How a Klarity visit fits

Klarity Health has 2,000+ licensed providers. Many mental health visits happen by video. A clinician can talk through psychosis, anxiety, depression, and sleep, then offer options that U.S. pharmacies stock. Coverage varies by plan. Self-pay is also an option. Check if your plan may cover a visit. Verify benefits before you book.

See online anxiety treatment options →

Browse condition pages →

FAQ

Is triflupromazine still available in the United States?

NCATS lists triflupromazine and triflupromazine hydrochloride as previously marketed and states that the drug was discontinued. There is no current DailyMed label. U.S. community pharmacies do not stock Vesprin.

What was Vesprin?

Vesprin was the brand of triflupromazine hydrochloride, first approved in 1957, used for psychosis and as an antiemetic.

Is triflupromazine a controlled substance?

Historic records do not assign a DEA schedule. It was a prescription phenothiazine, not a stimulant or benzodiazepine.

Can a telehealth clinician prescribe triflupromazine?

A U.S. clinician cannot fill a product that is not on the market. They can evaluate symptoms and discuss available antipsychotics.

What should I do if I still have old Vesprin tablets or vials?

Do not take expired or foreign leftover antipsychotics without a clinician. Bring the bottle to a pharmacist for disposal guidance and book a visit to review a current plan.

Educational only. Not medical advice. Coverage varies by plan. Verify benefits before booking. If you are in crisis, call or text 988.