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chlorpromazine

Pronunciation

Generic Name: chlorpromazine (oral) (klor PROE ma zeen)
Brand Name: Thorazine, Ormazine, Thorazine Spansule

What is chlorpromazine?

Chlorpromazine 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.

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

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

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

What is the most important information I should know about chlorpromazine?

Stop using this medicine and call your doctor at once if you have twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs. These could be early signs of dangerous side effects.

Chlorpromazine is not approved for use in psychotic conditions related to dementia. Chlorpromazine may increase the risk of death in older adults with dementia-related conditions.

What should I discuss with my healthcare provider before taking chlorpromazine?

You should not use this medicine if you are allergic to chlorpromazine or other phenothiazines (such as fluphenazine, perphenazine, prochlorperazine, promethazine, thioridazine, or trifluoperazine).

Do not take chlorpromazine if you have recently used large amounts of alcohol or taken a medicine that makes you sleepy.

Chlorpromazine is not approved for use in psychotic conditions related to dementia. Chlorpromazine may increase the risk of death in older adults with dementia-related conditions.

To make sure chlorpromazine is safe for you, tell your doctor if you have:

  • bone marrow suppression;

  • a brain tumor;

  • heart disease;

  • liver or kidney disease;

  • severe asthma, emphysema, or other breathing problem;

  • a history of breast cancer;

  • glaucoma;

  • seizures or epilepsy;

  • pheochromocytoma (tumor of the adrenal gland);

  • an enlarged prostate or urination problems; or

  • if you also take lithium or a blood thinner (warfarin, Coumadin).

Talk with your doctor before giving chlorpromazine to a child who has been ill with a fever or flu symptoms.

Tell your doctor if you will be exposed to extreme heat or cold, or to insecticide poisons while you are taking chlorpromazine.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking chlorpromazine, do not stop taking it without your doctor's advice.

Chlorpromazine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take chlorpromazine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using chlorpromazine.

If you need to have any type of x-ray scan or MRI of your spinal cord, tell the doctor ahead of time that you are using chlorpromazine. You may need to stop using the medicine for a short time.

Do not stop using chlorpromazine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using chlorpromazine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include dry mouth, bloating or stomach cramps, feeling restless or agitated, fever, muscle stiffness, jerky muscle movements, changes in heart rate, or seizure (convulsions).

What should I avoid while taking chlorpromazine?

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. Dangerous side effects could occur.

Avoid exposure to sunlight or tanning beds. Chlorpromazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Chlorpromazine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

High doses or long-term use of chlorpromazine can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take chlorpromazine, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women and older adults.

Call your doctor at once if you have:

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

  • stiffness in your neck, tightness in your throat, trouble breathing or swallowing;

  • sudden weakness or ill feeling, fever, chills, sore throat, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough;

  • pale skin, easy bruising or bleeding;

  • jaundice (yellowing of the skin or eyes); or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Older adults may be more likely to have side effects from this medication.

Common side effects may include:

  • drowsiness;

  • breast swelling or discharge;

  • changes in menstrual periods;

  • dry mouth or stuffy nose, blurred vision;

  • constipation; or

  • impotence, trouble having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Chlorpromazine dosing information

Usual Adult Dose for Mania:

HOSPITALIZED PATIENTS:
Acute Schizophrenia/Manic States:
Oral:
-Usual dose: 500 mg/day orally
-Maximum dose: 2000 mg/day

Parenteral:
-Usual dose: 25 mg IM once, with a subsequent 25 to 50 mg injection in 1 hour if necessary
-Maintenance dose: 400 mg IM every 4 to 6 hours until the patient is controlled

Prompt Control of Severe Symptoms:
Oral:
-Usual dose: After an initial IM dose, 25 to 50 mg orally 3 times a day

Parenteral:
-Usual dose: 25 mg IV once, repeated in 1 hour if necessary

Less Acutely Disturbed:
Oral:
-Initial dose: 25 mg orally 3 times a day
-Usual dose: 400 mg/day

OUTPATIENTS:
Oral:
-Usual dose: 10 mg orally 3 to 4 times a day OR 25 mg orally 2 to 3 times a day

More Severe Cases:
Oral:
-Usual dose: 25 mg orally 3 times a day, increasing by 20 to 50 mg at semiweekly intervals until the patient is calm and cooperative

Comments:
-Patients have experienced little therapeutic gain with doses over 1000 mg/day given for extended periods.
-Patients usually become quiet and cooperative within 24 and 48 hours.
-The dosage should be increased gradually until symptom improvement occurs; this dose should be continued for 2 weeks, and then gradually reduced to the lowest effective dose.
-Maximum improvement with oral formulations may take weeks to months.

Uses:
-Management of manifestations of psychotic disorders
-Treatment of schizophrenia
-To control the manifestations of the manic type of manic-depressive illness

Usual Adult Dose for Psychosis:

HOSPITALIZED PATIENTS:
Acute Schizophrenia/Manic States:
Oral:
-Usual dose: 500 mg/day orally
-Maximum dose: 2000 mg/day

Parenteral:
-Usual dose: 25 mg IM once, with a subsequent 25 to 50 mg injection in 1 hour if necessary
-Maintenance dose: 400 mg IM every 4 to 6 hours until the patient is controlled

Prompt Control of Severe Symptoms:
Oral:
-Usual dose: After an initial IM dose, 25 to 50 mg orally 3 times a day

Parenteral:
-Usual dose: 25 mg IV once, repeated in 1 hour if necessary

Less Acutely Disturbed:
Oral:
-Initial dose: 25 mg orally 3 times a day
-Usual dose: 400 mg/day

OUTPATIENTS:
Oral:
-Usual dose: 10 mg orally 3 to 4 times a day OR 25 mg orally 2 to 3 times a day

More Severe Cases:
Oral:
-Usual dose: 25 mg orally 3 times a day, increasing by 20 to 50 mg at semiweekly intervals until the patient is calm and cooperative

Comments:
-Patients have experienced little therapeutic gain with doses over 1000 mg/day given for extended periods.
-Patients usually become quiet and cooperative within 24 and 48 hours.
-The dosage should be increased gradually until symptom improvement occurs; this dose should be continued for 2 weeks, and then gradually reduced to the lowest effective dose.
-Maximum improvement with oral formulations may take weeks to months.

Uses:
-Management of manifestations of psychotic disorders
-Treatment of schizophrenia
-To control the manifestations of the manic type of manic-depressive illness

Usual Adult Dose for Schizophrenia:

HOSPITALIZED PATIENTS:
Acute Schizophrenia/Manic States:
Oral:
-Usual dose: 500 mg/day orally
-Maximum dose: 2000 mg/day

Parenteral:
-Usual dose: 25 mg IM once, with a subsequent 25 to 50 mg injection in 1 hour if necessary
-Maintenance dose: 400 mg IM every 4 to 6 hours until the patient is controlled

Prompt Control of Severe Symptoms:
Oral:
-Usual dose: After an initial IM dose, 25 to 50 mg orally 3 times a day

Parenteral:
-Usual dose: 25 mg IV once, repeated in 1 hour if necessary

Less Acutely Disturbed:
Oral:
-Initial dose: 25 mg orally 3 times a day
-Usual dose: 400 mg/day

OUTPATIENTS:
Oral:
-Usual dose: 10 mg orally 3 to 4 times a day OR 25 mg orally 2 to 3 times a day

More Severe Cases:
Oral:
-Usual dose: 25 mg orally 3 times a day, increasing by 20 to 50 mg at semiweekly intervals until the patient is calm and cooperative

Comments:
-Patients have experienced little therapeutic gain with doses over 1000 mg/day given for extended periods.
-Patients usually become quiet and cooperative within 24 and 48 hours.
-The dosage should be increased gradually until symptom improvement occurs; this dose should be continued for 2 weeks, and then gradually reduced to the lowest effective dose.
-Maximum improvement with oral formulations may take weeks to months.

Uses:
-Management of manifestations of psychotic disorders
-Treatment of schizophrenia
-To control the manifestations of the manic type of manic-depressive illness

Usual Adult Dose for Nausea/Vomiting:

Oral:
-Usual dose: 10 to 25 mg orally every 4 to 6 hours as needed for nausea/vomiting

Parenteral:
-Usual dose: 25 mg IM once. If hypotension does not occur, administer 25 to 50 mg IM every 3 to 4 hours as needed until vomiting stops, and then patients should be switched to oral formulations.

Nausea/Vomiting During Surgery:
IM:
-Usual dose: 12.5 mg IM, repeated in 30 minutes as needed AND in the absence of hypotension
IV:
-Usual dose: 2 mg IV every 2 minutes, diluted to 1 mg/mL
-Maximum IV dose: 25 mg

Comment:
-The frequency of dosing in the oral formulations may be increased if necessary.

Use: To control nausea and vomiting

Usual Adult Dose for Light Sedation:

Oral:
-Usual dose: 25 to 50 mg orally 2 to 3 hours before the operation

Parenteral:
-Usual dose: 12.5 to 25 mg IM 1 to 2 hours before the operation

Use: Relief of restlessness and apprehension before surgery

Usual Adult Dose for Hiccups:

Oral:
-Usual dose: 25 to 50 mg orally 3 to 4 times a day

Parenteral:
-If symptoms persist after 2 to 3 days with oral therapy: 25 to 50 mg IM once
-Symptoms that persist after IM administration: 25 to 50 mg slow IV infusion in 500 to 1000 mL of saline

Comments:
-If symptoms persist after 2 to 3 days with oral formulations, parenteral therapy should be started.
-Slow IV infusions should be administered to patients who are lying flat in bed, and blood pressure should be monitored closely.

Use: For relief of intractable hiccups

Usual Adult Dose for Porphyria:

Oral:
-Usual dose: 25 to 50 mg orally 3 to 4 times a day

Parenteral:
-Usual dose: 25 mg IM 3 to 4 times a day, continued until the patient is able to take oral formulations

Comments:
-Patients usually may discontinue treatment after several weeks; however, some may require maintenance therapy.
-Parenteral formulations: Patients should lay down prior to and at least 30 minutes after administration.

Use: Acute intermittent porphyria

Usual Adult Dose for Tetanus:

Parenteral:
IM:
-Usual dose: 25 to 50 mg IM 3 to 4 times a day, usually with barbiturates

IV:
-Usual dose: 25 to 50 mg IV, diluted to at least 1 mg/mL and given at a rate of 1 mg/min

Comments:
-Patients should be started on low IM doses; subsequent dosing and frequency should be determined by patient response.
-IM doses should be given slowly.
-Patients should lay down prior to and at least 30 minutes after administration.

Use: Adjunct to the treatment of tetanus

Usual Pediatric Dose for Aggressive Behavior:

6 months to 12 years:
INPATIENTS:
Severe Behavior Disorders:
-Usual dose: 50 to 100 mg/day orally or IM (younger patients); at least 200 mg/day orally or IM (older patients)
-Maximum IM dose: 40 mg/day (up to 5 years OR 22.7 kg); 75 mg/day (5 to 12 years OR 22.7 to 45.5 kg)

OUTPATIENTS:
Oral:
-Usual dose: 0.55 mg/kg orally every 4 to 6 hours as needed
Parenteral:
-Usual dose: 0.55 mg/kg IM every 6 to 8 hours as needed

Comments:
-Route of administration should be determined by the condition of the patient.
-Patients with mental disabilities who are disturbed have experienced little therapeutic gain with doses over 500 mg/day.

Uses:
-Treatment of severe behavioral problems marked by combativeness and/or explosive hyperexcitable behavior (out of proportion to immediate provocation)
-Short-term treatment of hyperactive children with excessive motor activity and accompanying conduct disorders marked by impulsivity, difficulty sustaining attention, aggressiveness, mood lability, and/or poor frustration tolerance

Usual Pediatric Dose for Nausea/Vomiting:

Oral:
-Usual dose: 0.55 mg/kg orally every 4 to 6 hours as needed

Parenteral:
-Usual dose: 0.55 mg/kg IM every 6 to 8 hours as needed
-Maximum dose: 40 mg/day (up to 22.7 kg); 75 mg/day (22.7 to 45.5 kg)

Nausea/Vomiting During Surgery:
IM:
-Usual dose: 0.275 mg/kg IM, repeated in 30 minutes as needed AND in the absence of hypotension
IV:
-Usual dose: 1 mg IV every 2 minutes, diluted to 1 mg/mL
-Maximum dose: 40 mg/day (up to 22.7 kg); 75 mg/day (22.7 to 45.5 kg)

Comment:
-The duration of action for parenteral doses may last up to 12 hours.

Use: To control nausea and vomiting

Usual Pediatric Dose for Light Sedation:

Oral:
-Usual dose: 0.55 mg/kg orally 2 to 3 hours before the operation

Parenteral:
-Usual dose: 0.55 mg/kg IM 1 to 2 hours before the operation

Use: Relief of restlessness and apprehension before surgery

Usual Pediatric Dose for Tetanus:

6 months to 12 years:
Parenteral:
IM:
-Usual dose: 0.55 mg/kg IM every 6 to 8 hours
-Maximum dose: 40 mg/day (up to 22.7 kg); 75 mg/day (22.7 to 45.5 kg)

IV:
-Usual dose: 0.55 mg/kg IV, diluted to at least 1 mg/mL and given at a rate of 0.5 mg/min
-Maximum dose: 40 mg/day (up to 22.7 kg); 75 mg/day (22.7 to 45.5 kg)

Comments:
-Patients should be started on low IM doses; subsequent dosing and frequency should be determined by patient response.
-Patients weighing 22.7 to 45.5 kg should not exceed 75 mg/day except in severe cases.
-Patients should lay down prior to and at least 30 minutes after administration.

Use: Adjunct to the treatment of tetanus

What other drugs will affect chlorpromazine?

Taking chlorpromazine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with chlorpromazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about chlorpromazine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.03.

Date modified: November 30, 2016
Last reviewed: October 20, 2016

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