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Prochlorperazine Side Effects

For the Consumer

Applies to prochlorperazine: oral tablets, parenteral injection, rectal suppositories

Side effects include:

Drowsiness, dizziness, amenorrhea, blurred vision, skin reactions, hypotension.

For Healthcare Professionals

Applies to prochlorperazine: compounding powder, injectable solution, oral capsule extended release, oral syrup, oral tablet, rectal suppository

Hematologic

Very common (10% or more): Mild leukopenia (up to 30%)
Rare (0.01% to 0.1%): Blood dyscrasia
Frequency not reported: Agranulocytosis, pancytopenia, thrombocytopenic purpura, thrombocytopenia, leukopenia, eosinophilia, hemolytic anemia, aplastic anemia, atypical lymphocytes[Ref]

Blood dyscrasias included pancytopenia, thrombocytopenic purpura, leukopenia, agranulocytosis, eosinophilia, hemolytic anemia, and aplastic anemia.

Mild leukopenia occurred in patients given high doses for prolonged durations.[Ref]

Nervous system

Common (1% to 10%): Drowsiness, dyskinesia, akathisia, parkinsonism, tremor/tremulousness
Frequency not reported: Convulsion, grand mal/petit mal convulsion, seizures, dizziness, altered consciousness, extrapyramidal reactions, dystonia/acute dystonia/acute dystonic reactions, akinesia, tardive dyskinesia, autonomic dysfunction, headache, opisthotonos, hyperreflexia, neuroleptic malignant syndrome, cerebral edema, EEG changes, altered cerebrospinal fluid proteins[Ref]

Acute dystonia was usually transitory, but was more commonly reported in young adults and children shortly after beginning treatment or increasing the dosage.

Akathisia usually occurred in patients who were given large initial doses.

Autonomic dysfunction included dry mouth, nasal congestion, headache, nausea, constipation, obstipation, adynamic ileus, ejaculatory disorders/impotence, priapism, atonic colon, urinary retention, miosis, and mydriasis.

Extrapyramidal reactions include acute dystonia, akathisia, parkinsonism, and tardive dyskinesia. These reactions have lasted months to years, especially in elderly patients with brain damage.

Grand and petit mal convulsions have occurred in patients with/with a history of EEG abnormalities.

Parkinsonism typically occurred in adults and elderly patients after weeks to months of treatment, and included tremor, rigidity, akinesia, and most commonly, tremor.[Ref]

Gastrointestinal

Common (1% to 10%): Constipation, dry mouth
Frequency not reported: Gum/mouth irritation, obstipation, atonic colon, paralytic/adynamic ileus, nausea and vomiting[Ref]

Ocular

Lenticular and corneal deposits occurred in patients who received large doses over a prolonged duration.[Ref]

Common (1% to 10%): Blurred vision
Frequency not reported: Oculogyric crisis, ocular changes, miosis, mydriasis, pigmentary retinopathy, lenticular and corneal deposits[Ref]

Musculoskeletal

Common (1% to 10%): Rigidity
Frequency not reported: Trismus, torticollis, systemic lupus erythematosus-like syndrome[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Hypotension, peripheral edema, cardiac arrhythmia, ECG changes, QT prolongation, deep vein thrombosis, venous thromboembolism, cyanosis, sudden death of cardiac origin
Frequency not reported: Fatal hypotension, orthostatic hypotension, ST depression, ventricular/atrial arrhythmias, atrioventricular block, ventricular tachycardia, ventricular fibrillation, cardiac arrest, U-Wave and T-Wave changes/distortions[Ref]

Cardiovascular side effects may be correlated with higher doses and may occur more frequently in patients with risk factors (e.g., patients with cardiac disease, hypokalemia, receiving tricyclic antidepressants, and/or who are elderly).

Cyanosis occurred in pediatric patients who developed laryngospasm form serious dystonic tractions.

Hypotension occurred more frequently in patients who received IM doses of this drug.[Ref]

Hepatic

Elevated bilirubin and hepatic enzyme levels occurred in patients who developed cholestatic jaundice.[Ref]

Uncommon (0.1% to 1%): Elevated bilirubin and hepatic enzyme levels
Rare (0.01% to 0.1%): Jaundice/transient jaundice
Frequency not reported: Liver damage, cholestatic jaundice, cholestasis/biliary stasis[Ref]

Other

Mild fever usually occurred after patients were given large IM doses.[Ref]

Uncommon (0.1% to 1%): Sudden death/unexplained sudden death
Frequency not reported: Neonatal drug withdrawal syndrome, hyperthermia, hyperpyrexia, mild fever, reversed epinephrine effect, intensification and prolongation of the action of atropine, heat, organophosphorous insecticides, and central nervous system depressants (e.g., opiates, analgesics, antihistamines, barbiturates, alcohol)[Ref]

Genitourinary

Very rare (less than 0.01%): Galactorrhea, amenorrhea/menstrual irregularities
Frequency not reported: Ejaculation disorder/inhibition, priapism, impotence, lactation, urinary retention[Ref]

Endocrine

Very rare (less than 0.01%): Hyperprolactinemia/elevated prolactin levels, gynecomastia,
Frequency not reported: Endocrine disturbances, syndrome of inappropriate antidiuretic hormone secretion (SIADH), false-positive pregnancy tests[Ref]

Dermatologic

Frequency not reported: Rash, dermatitis, skin disorders/reaction, photosensitivity, itching, erythema, urticaria, eczema, exfoliative dermatitis, angioneurotic edema, contact skin sensitization/dermatitis, maculopapular eruptions, erythema multiforme, abnormal pigmentation/skin pigmentation and epithelial keratopathy[Ref]

Skin pigmentation and epithelial keratopathy occurred in patients who received large doses over a prolonged duration.[Ref]

Psychiatric

Frequency not reported: Insomnia, agitation, activation/reactivation of psychotic processes, catatonia/catatonic-like states[Ref]

Metabolic

Frequency not reported: Hyponatremia, hyperglycemia, hypoglycemia, increased appetite, increased weight, impaired glucose tolerance[Ref]

Respiratory

Frequency not reported: Asthma, laryngeal edema, pulmonary embolism/fatal pulmonary embolism, nasal stuffiness/congestion, respiratory depression[Ref]

Hypersensitivity

Frequency not reported: Angioedema, anaphylactoid reactions, hypersensitivity reactions/type I hypersensitivity reaction[Ref]

Local

Frequency not reported: Metallic gray-mauve coloration to exposed skin[Ref]

Renal

Frequency not reported: Glycosuria[Ref]

References

1. Cerner Multum, Inc. "Australian Product Information." O 0

2. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

It is possible that some side effects of prochlorperazine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.

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