Chlorpromazine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Psychosis

IM: Initial Dose 25 to 50 mg. The dose may be repeated in one hour. Subsequent doses may be increased and given every 2 to 4 hours as needed.

Oral: Initial Dose: 10 to 25 mg orally 3 times a day. Total daily doses should be increased in 20 to 50 mg increments every 3 or 4 days until symptoms are controlled.
Usual Maintenance Dose: 200 mg/day orally
Some patients require higher dosages (e.g., 800 mg daily is not uncommon in discharged mental patients). Increase dosage gradually until symptoms are controlled. Maximum improvement may not be seen for weeks or even months. Continue optimum dosage for 2 weeks, then gradually reduce dosage to the lowest effective maintenance level.

Usual Adult Dose for Mania

Oral: 10 mg orally 3 to 4 times a day or 25 mg orally 2 to 3 times a day.
More severe cases: 25 mg orally 3 times a day.
After 1 to 2 days, dose may be increased by 20 to 50 mg/day at semiweekly intervals.
Prompt control of severe symptoms: 25 mg IM one time.
If necessary, repeat in 1 hour. Subsequent doses should be oral, 25 to 50 mg three times a day.

IM: 25 mg injection one time. If necessary, may give additional 25 to 50 mg injection in 1 hour.
Increase subsequent doses gradually over several days up to 400 mg every 4 to 6 hours in exceptionally severe cases.
Usually patient becomes quiet and cooperative within 24 to 48 hours and oral doses may be substituted.
Oral: 500 mg/day is generally sufficient. Gradual increases to 2000 mg/day or more may be necessary.
There is usually little therapeutic gain to be achieved by exceeding 1000 mg/day for extended periods.
Less acutely disturbed Oral: 25 mg three times a day.
May increase gradually until effective dose is reached, usually 400 mg/day.

Usual Adult Dose for Nausea/Vomiting

Oral: 10 to 25 mg every 4 to 6 hours as needed. May increase, if necessary.
IM: 25 mg one time. If no hypotension occurs, give 25 to 50 mg every 3 to 4 hours as needed, then switch to oral dosage.
Rectal: One 100 mg suppository every 6 to 8 hours as needed. In some patients, half this dose will do.

Nausea/Vomiting During Surgery:
IM: 12.5 mg one time. May repeat in 30 minutes if necessary and if no hypotension occurs.
IV: 2 mg at 2 minute intervals. Do not exceed 25 mg. Dilute to 1 mg/mL.

Usual Adult Dose for Light Sedation

For light sedation prior to a medical or surgical procedure:

Oral: 25 to 50 mg, 2 to 3 hours before the operation.
IM: 12.5 to 25 mg, 1 to 2 hours before operation.

Usual Adult Dose for Hiccups

Oral: 25 to 50 mg 3 to 4 times a day.
IM: If symptoms persist for 2 to 3 days, give 25 to 50 mg IM.
IV infusion: Should symptoms persist, use slow IV infusion: 25 to 50 mg in 500 to 1000 mL of saline.

Usual Adult Dose for Porphyria

Oral: 25 to 50 mg 3 to 4 times a day.
Can usually be discontinued after several weeks, but maintenance therapy may be necessary for some patients.
IM: 25 mg injection 3 to 4 times a day until patient can take oral therapy.

Usual Adult Dose for Tetanus

IM: 25 to 50 mg given 3 to 4 times daily, usually in conjunction with barbiturates. Total doses and frequency of administration must be determined by the patient's response, starting with low doses and increasing gradually.
IV: 25 to 50 mg diluted to at least 1 mg/mL and administered at a rate of 1 mg/min.

Usual Pediatric Dose for Opiate Withdrawal

less than 1 month:
Neonatal abstinence syndrome (withdrawal from maternal opioid use; controls CNS and gastrointestinal symptoms):
Intramuscular: Initial: 0.55 mg/kg/dose given every 6 hours; change to oral after approximately 4 days, decrease dose gradually over 2 to 3 weeks. Note: Chlorpromazine is rarely used for neonatal abstinence syndrome due to adverse effects such as hypothermia, cerebellar dysfunction, decreased seizure threshold, and eosinophilia; other agents are preferred.

Usual Pediatric Dose for Schizophrenia

6 months and older:
Oral: 0.5 to 1 mg/kg/dose orally every 4 to 6 hours; older children may require 200 mg/day or higher
intramuscular or intravenous: 0.5 to 1 mg/kg/dose every 6 to 8 hours
Maximum recommended doses:
less than 5 years (less than 22.7 kg): 40 mg/day
5 years and older: (22.7 to 45.5 kg): 75 mg/day

Usual Pediatric Dose for Nausea/Vomiting

Nausea and vomiting:
Oral: 0.5 to 1 mg/kg/dose every 4 to 6 hours as needed
intramuscular or intravenous: 0.5 to 1 mg/kg/dose every 6 to 8 hours;

Maximum recommended doses:
less than 5 years (less than 22.7 kg): 40 mg/day
5 and older (22.7-45.5 kg): 75 mg/day

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Adjust dosage to individual and the severity of condition, recognizing that the mg for mg potency relationship among all dosage forms has not been precisely established clinically. It is important to increase dosage until symptoms are controlled. Dosage should be increased more gradually in debilitated or emaciated patients. In continued therapy, gradually reduce dosage to the lowest effective maintenance level, after symptoms have been controlled for a reasonable period.
In general, dosage recommendations for other oral forms of the drug may be applied to the sustained release capsules on the basis of total daily dosage in milligrams.
The 100 mg and 200 mg tablets are for use in severe neuropsychiatric conditions.

Precautions

In general, dosage levels should be lower in the elderly, the emaciated and the debilitated. Chlorpromazine should be used cautiously in patients with cardiovascular, liver or renal disease.

Dialysis

Data not available

Other Comments

Chlorpromazine should generally not be used in children under 6 months of age except where potentially lifesaving.

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