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prochlorperazine

Pronunciation

Generic Name: prochlorperazine (oral) (pro klor PER a zeen)
Brand Name: Compazine

What is oral prochlorperazine?

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

Prochlorperazine oral (taken by mouth) is used to treat psychotic disorders such as schizophrenia. It is also used to treat anxiety, and to control severe nausea and vomiting.

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

What is the most important information I should know about oral prochlorperazine?

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

You should not use prochlorperazine if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications.

What should I discuss with my healthcare provider before taking oral prochlorperazine?

You should not use prochlorperazine if you are allergic to it, or if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications.

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

Long-term use of prochlorperazine can cause a serious movement disorder that may not be reversible. The longer you take prochlorperazine, the more likely you are to develop this movement disorder. The risk of this side effect is higher in women and older adults.

Do not give this medication to a child or teenager with a fever, flu symptoms, or an infectious disease such as chickenpox, measles, stomach flu, or an infection of the central nervous system.

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

  • bladder obstruction or other urination problems;

  • a blockage in your intestines;

  • severe asthma or other breathing problem;

  • glaucoma;

  • heart disease, high blood pressure;

  • past or present breast cancer;

  • liver or kidney disease;

  • adrenal gland tumor (pheochromocytoma);

  • seizures, or a history of brain tumor;

  • Parkinson's disease;

  • if you have ever had a serious side effect while using prochlorperazine or another phenothiazine; or

  • if you also take certain other medications--lithium, propranolol, a diuretic or "water pill," a blood thinner (warfarin, Coumadin), or seizure medication.

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

It is not known whether prochlorperazine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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 prochlorperazine, do not stop taking it without your doctor's advice.

Prochlorperazine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Prochlorperazine is not for use in children younger than 2 years old or weighing less than 20 pounds. Talk with your doctor before giving this medication to a child who has been ill with a fever or flu symptoms.

How should I take oral prochlorperazine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

If you take prochlorperazine long-term, you may need frequent medical tests.

If you need to have an x-ray or CT scan of your spinal column using a dye that is injected into a vein, you may need to temporarily stop taking prochlorperazine. Be sure the doctor knows ahead of time that you are taking this medication.

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

Store at room temperature away from moisture, heat, and light.

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 can cause severe drowsiness, irregular heartbeats, feeling restless and agitated, or seizure (convulsions).

What should I avoid while taking oral prochlorperazine?

Drinking alcohol can increase certain side effects of prochlorperazine.

This medication may cause drowsiness or blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. 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.

Oral prochlorperazine 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.

Stop taking prochlorperazine and call your doctor at once if you have any of these signs of a serious movement disorder:

  • tremors or shaking in your arms or legs;

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

  • any new or unusual muscle movements you cannot control.

Also call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • little or no urinating;

  • feeling restless, jittery, or agitated;

  • jaundice (yellowing of the skin or eyes);

  • slow heart rate, weak pulse, fainting, slow breathing;

  • decreased white blood cells--sudden weakness or ill feeling, fever, chills, sore throat, flu symptoms, mouth sores, trouble swallowing;

  • lupus-like syndrome--joint pain or swelling with fever, swollen glands, muscle aches, chest pain, vomiting, unusual thoughts or behavior, and patchy skin color; or

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

Common side effects may include:

  • headache, dizziness, drowsiness;

  • blurred vision;

  • dry mouth, stuffy nose;

  • constipation;

  • mild itching or rash;

  • missed menstrual periods; or

  • sleep problems (insomnia).

Side effects such as painful or difficult urination, constipation, and confusion may be more likely in older adults.

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)

Prochlorperazine dosing information

Usual Adult Dose for Nausea/Vomiting:

Severe Nausea and Vomiting:
Oral:
-Usual dose: 5 to 10 mg orally 3 to 4 times a day
-Maximum dose: 40 mg/day

Parenteral:
IM:
-Usual dosage: 5 to 10 mg IM, repeated every 3 to 4 hours as necessary.
-Maximum dose: 40 mg/day

IV:
-Usual dose: 2.5 to 10 mg slow IV injection or infusion at a rate not exceeding 5 mg/min
-Maximum dose: 10 mg (single dose); 40 mg/day

Rectal:
-Usual dose: 25 mg rectally 2 times a day

Adult Surgery (Severe Nausea and Vomiting):
Parenteral:
IM:
-Usual dose: 5 to 10 mg IM 1 to 2 hours before anesthesia OR to control acute symptoms during/after surgery, repeated once (in 30 minutes) if necessary
-Maximum dose: 40 mg/day

IV:
-Usual dose: 5 to 10 mg slow IV injection or infusion (at a rate not exceeding 5 mg/min) 15 to 30 minutes before anesthesia OR to control acute symptoms during/after surgery, repeated once if necessary
-Maximum dose: 10 mg (single dose)

Comments:
-Resistant cases may require oral doses exceeding 40 mg/day.
-Patients receiving parenteral formulations may be more likely to experience hypotension.
-This drug may be given as an undiluted or diluted IV solution; however, bolus IV injections should be avoided.

Use: Control of severe nausea and vomiting

Usual Adult Dose for Anxiety:

Oral:
-Usual dose: 5 mg orally 3 to 4 times a day
-Maximum dose: 20 mg/day
-Duration of therapy: Up to 12 weeks

Use: Short-term treatment of generalized non-psychotic anxiety

Usual Adult Dose for Psychosis:

Mild psychotic disorders:
-Usual dose: 5 to 10 mg orally 3 to 4 times a day

Moderate to severe psychotic disorders:
Oral:
-Initial dose: 10 mg orally 3 to 4 times a day, increasing the dose in small increments every 2 to 3 days until symptoms are controlled or side effects become bothersome
-Maintenance dose: 50 to 75 mg/day for some patients; 100 to 150 mg/day for patients with more severe disturbances

Parenteral:
-Initial dose: 10 to 20 mg IM, repeated every 2 to 4 hours (or every hour in resistant cases), if necessary
-Prolonged therapy: 10 to 20 mg IM every 4 to 6 hours

Comments:
-Many patients respond after the first injection; more than 3 to 4 IM doses are seldom required.
-Once patients are controlled on parenteral formulations, oral formulations should be used at the same dose or higher. Prolonged IM therapy should be used in rare cases.

Use: Treatment of schizophrenia

Usual Adult Dose for Schizophrenia:

Mild psychotic disorders:
-Usual dose: 5 to 10 mg orally 3 to 4 times a day

Moderate to severe psychotic disorders:
Oral:
-Initial dose: 10 mg orally 3 to 4 times a day, increasing the dose in small increments every 2 to 3 days until symptoms are controlled or side effects become bothersome
-Maintenance dose: 50 to 75 mg/day for some patients; 100 to 150 mg/day for patients with more severe disturbances

Parenteral:
-Initial dose: 10 to 20 mg IM, repeated every 2 to 4 hours (or every hour in resistant cases), if necessary
-Prolonged therapy: 10 to 20 mg IM every 4 to 6 hours

Comments:
-Many patients respond after the first injection; more than 3 to 4 IM doses are seldom required.
-Once patients are controlled on parenteral formulations, oral formulations should be used at the same dose or higher. Prolonged IM therapy should be used in rare cases.

Use: Treatment of schizophrenia

Usual Pediatric Dose for Nausea/Vomiting:

Less than 2 years or less than 9 kg: Use is contraindicated

2 years and older:
Oral:
9 to 13 kg: 2.5 mg orally 1 to 2 times a day; maximum dose is 7.5 mg/day
13 to 18 kg: 2.5 mg orally 2 to 3 times a day; maximum dose is 10 mg/day
18 to 39 kg: 2.5 mg orally 3 times a day OR 5 mg orally 2 times a day; maximum dose is 15 mg/day

Parenteral:
-Usual dose: 0.132 mg/kg IM once

Comments:
-At moderate doses, pediatric patients may be more prone to extrapyramidal reactions. Patients should receive the lowest effective dose.
-Continued oral treatment after day 1, and parenteral treatment after the first dose is usually not necessary.

Use: Control of severe nausea and vomiting

Usual Pediatric Dose for Schizophrenia:

Less than 2 years or less than 9 kg: Use is contraindicated

2 to 12 years:
Oral:
-Initial dose: 2.5 mg orally 2 to 3 times a day
-Maximum dose: 20 mg/day (2 to 5 years); 25 mg/day (6 to 12 years)

Parenteral:
-Usual dose: 0.132 mg/kg IM once

Comments:
-Patients should not receive more than 10 mg of the oral formulation on the first day of treatment. Dose adjustments may be made after the first day.
-At moderate doses, pediatric patients may be more prone to extrapyramidal reactions. Patients should receive the lowest effective dose.
-When symptoms are controlled with the IM formulation, patients should be switched to oral formulations at the same dose or higher.

Use: Treatment of schizophrenia

What other drugs will affect oral prochlorperazine?

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

Many drugs can interact with prochlorperazine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with prochlorperazine.

Where can I get more information?

  • Your pharmacist can provide more information about oral prochlorperazine.
  • 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: 9.01.

Date modified: November 30, 2016
Last reviewed: July 14, 2014

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