Prochlorperazine
Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Phenothiazine
Controlled Drug Substance
NO

Prochlorperazine
Summary
Prochlorperazine is used to treat conditions like nausea and vomiting often related to surgery, cancer treatments or other medical conditions. It's also used in managing symptoms of schizophrenia like delusions and hallucinations, and anxiety. It can also treat vertigo or dizziness related to inner ear problems, and psychotic disorders.
Prochlorperazine works by blocking the action of certain neurotransmitters in the brain, particularly dopamine, which is involved in regulating mood, behavior, and coordination. This helps reduce symptoms of nausea, vomiting, and vertigo. In the treatment of psychotic disorders, it helps manage symptoms like delusions and hallucinations.
For nausea and vomiting, the usual dosage is 5-10 mg 3-4 times a day. For schizophrenia or anxiety, the initial dose is typically 5-10 mg 2-3 times daily. The medication can be taken with or without food, and it can be swallowed whole with a glass of water. If using the suppository form, follow your doctor's specific instructions for insertion.
The most common side effects of Prochlorperazine include drowsiness, dizziness, dry mouth, and constipation. More significant adverse effects may include extrapyramidal symptoms such as tremors, rigidity, and abnormal movements, tardive dyskinesia, neuroleptic malignant syndrome, and hypotension. Rare but severe reactions include severe allergic reactions and seizures.
Important warnings include the risk of extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome, which can be life-threatening. It should be used cautiously in people with a history of seizures, liver disease, or heart problems. Contraindications include hypersensitivity to the drug and conditions like severe CNS depression or coma.
Indications and Purpose
How does Prochlorperazine work?
Prochlorperazine is an antipsychotic and antiemetic medication that works by blocking the action of certain neurotransmitters in the brain, particularly dopamine. Dopamine is involved in regulating mood, behavior, and coordination. By inhibiting dopamine receptors, Prochlorperazine helps reduce symptoms of nausea, vomiting, and vertigo. In the treatment of psychotic disorders, this action helps manage symptoms like delusions and hallucinations. It also has sedative properties, which can aid in reducing anxiety.
Is Prochlorperazine effective?
Evidence supporting the effectiveness of Prochlorperazine comes from multiple clinical studies that show its efficacy in treating nausea, vomiting, and vertigo related to various conditions like motion sickness, chemotherapy, and dizziness. Additionally, its use in managing symptoms of schizophrenia and anxiety has been validated through randomized controlled trials, demonstrating significant improvements in psychotic symptoms and behavioral control in patients with psychiatric disorders.
What is Prochlorperazine?
Prochlorperazine is commonly used to treat nausea, vomiting, and symptoms of vertigo, as well as to manage certain psychiatric conditions like schizophrenia and anxiety. It works by blocking dopamine receptors in the brain, which helps reduce nausea and vomiting and can have a calming effect on mood and behavior. It is also sometimes used to treat severe agitation and anxiety.
Directions for Use
For how long do I take Prochlorperazine?
For long-term treatment, it's important to use the lowest dose that works for the shortest time possible. Check in with your doctor regularly to see if you can lower your dose or stop taking your medication. Older people may need lower doses because they're more sensitive to side effects.
How do I dispose of Prochlorperazine?
If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.
How do I take Prochlorperazine?
Prochlorperazine can be taken with or without food. There are no specific food restrictions for most people using this medication. However, taking it with food may help reduce potential stomach upset. If you experience drowsiness, it may be helpful to take it at bedtime. Avoid alcohol, as it can enhance drowsiness and other side effects. Follow your healthcare provider’s instructions for proper use and dosage.
How long does it take for Prochlorperazine to start working?
Prochlorperazine usually starts working within 30 to 60 minutes after oral administration, particularly for nausea and vomiting. The full effects may take a few hours to develop. For other conditions, such as anxiety or agitation, it may take longer to notice improvements, depending on the dosage and individual response.
How should I store Prochlorperazine?
Keep the medicine at room temperature between 68°F and 77°F (20°C to 25°C). Short-term storage is allowed between 59°F to 86°F (15°C to 30°C).
What is the usual dose of Prochlorperazine?
For adults, the usual dose of prochlorperazine is:
- Oral: 5-10 mg taken 3 to 4 times daily, with a maximum of 40 mg per day.
- Rectal: 25 mg twice daily for severe nausea and vomiting.
For children, dosing varies by weight:
- Under 2 years or <20 lbs: Not recommended.
- 20-29 lbs: 2.5 mg once or twice daily, max 7.5 mg/day.
- 30-39 lbs: 2.5 mg 2-3 times daily, max 10 mg/day.
- 40-85 lbs: 2.5 mg 3 times daily or 5 mg twice daily, max 15 mg/day
Warnings and Precautions
Can I take Prochlorperazine with other prescription drugs?
Prochlorperazine may interact with several prescription drugs, including:
- Central Nervous System Depressants: Combining with sedatives, alcohol, or benzodiazepines (e.g., diazepam) can enhance drowsiness or sedation.
- Antidepressants: Concurrent use with SSRIs or SNRIs may increase the risk of serotonin syndrome.
- Antihypertensive Medications: It may enhance the blood pressure-lowering effects of medications like ACE inhibitors or beta-blockers.
- Anticholinergics: Increased risk of anticholinergic side effects (e.g., dry mouth, blurred vision).
Can Prochlorperazine be taken safely while breastfeeding?
Prochlorperazine is excreted in breast milk, and its use during breastfeeding is generally not recommended unless absolutely necessary. It can potentially cause sedation, extrapyramidal symptoms, or other side effects in the infant. If the medication is required, a healthcare provider may suggest temporary discontinuation of breastfeeding or closely monitor the infant for any adverse effects. Always consult with a doctor before using this medication while breastfeeding.
Can Prochlorperazine be taken safely while pregnant?
Prochlorperazine is classified as a Category C drug during pregnancy by the FDA, meaning that there is no adequate, well-controlled study in pregnant women. Animal studies have shown adverse effects on the fetus, but the potential risks to humans are not fully known. It should be used only if the potential benefits outweigh the risks, especially in the first trimester. Always consult a healthcare provider before use during pregnancy.
Does Prochlorperazine have adverse effects?
Adverse effects, which are unwanted or harmful reactions to a medicine, can occur when taking any medication. For this medicine, common adverse effects might include nausea, headache, dizziness, fatigue, and dry mouth. These effects can vary in frequency, with some people experiencing them more often than others. Rare but serious adverse effects could include severe allergic reactions, which might cause difficulty breathing or swelling of the face and throat, and require immediate medical attention. It's crucial to report any new or worsening symptoms to a healthcare provider. Never stop taking a medicine without consulting a healthcare professional, as they can provide guidance on managing side effects or adjusting treatment if necessary.
Does Prochlorperazine have any safety warnings?
To determine if a medicine has safety warnings, you should first check the prescription information provided with the medicine. This information often includes a section on warnings and precautions. For example, if the medicine is a blood thinner, it may have a warning about increased risk of bleeding. This is because blood thinners prevent blood clots, which can also make it easier to bleed. The consequences of not monitoring this warning could be serious bleeding events. Symptoms to watch for include unusual bruising, prolonged bleeding from cuts, or blood in urine or stool. If you notice any of these signs, contact a healthcare provider immediately. Always read the prescription information carefully and discuss any concerns with your doctor or pharmacist.
Is it safe to drink alcohol while taking Prochlorperazine?
No, alcohol increases sedation and dizziness when combined with Prochlorperazine. Avoid drinking while on this medication.
Is it safe to exercise while taking Prochlorperazine?
Exercise is safe but avoid strenuous activities if feeling dizzy or tired. Always stay hydrated and exercise with caution.
Is it safe to stop Prochlorperazine?
To determine if it's safe to stop a medicine, first consider its purpose. If it's for a chronic condition like hypertension or diabetes, stopping it suddenly can lead to serious health risks, such as uncontrolled blood pressure or blood sugar levels. For medicines providing symptomatic relief or treating temporary conditions, stopping might lead to the return of symptoms or incomplete treatment of the condition. Some medicines can cause withdrawal symptoms or rebound effects, where symptoms return worse than before. Abruptly stopping certain medicines can be life-threatening, especially those affecting the heart or brain. Always consult a doctor before stopping any medicine to ensure it's done safely and appropriately.
Is Prochlorperazine addictive?
This medicine does not have any known potential for dependence or addiction. It is considered safe in terms of habit-forming properties. Therefore, there is no need to worry about developing a physical or psychological dependence on this medication. However, it is always important to use any medication as directed by a healthcare professional to ensure safety and effectiveness. If you have any concerns or questions about your medication, it is best to discuss them with your doctor or pharmacist.
Is Prochlorperazine safe for the elderly?
When prescribing prochlorperazine to elderly patients, several recommendations and warnings should be considered:
- Lower Dosage: Begin with a lower dose due to increased sensitivity to side effects, particularly hypotension and sedation.
- Risk of Mortality: There is an increased risk of death in elderly patients with dementia-related psychosis treated with antipsychotics, including prochlorperazine. This medication is not approved for this population.
- Monitoring: Regularly monitor for adverse effects such as extrapyramidal symptoms and changes in renal, hepatic, or cardiac function.
- Caution with Comorbidities: Adjust doses carefully in patients with multiple health issues or those on other medications affecting blood pressure.
What are the most common side effects of Prochlorperazine?
A side effect is an unwanted or unexpected symptom caused by a medicine. For this medicine, common side effects may include nausea, which is feeling sick to your stomach, dizziness, which is feeling lightheaded or unsteady, headache, which is pain in the head, fatigue, which is feeling very tired, and dry mouth, which is a lack of saliva. The frequency of these side effects can vary, but they are generally considered common. It's important to note that when starting a new medicine, people might experience new symptoms that could be coincidental, unrelated, or temporary. These symptoms might also be due to another health issue. Always talk to a healthcare provider before stopping any medicine, as they can provide guidance on managing side effects and ensure your treatment is safe and effective.
Who should avoid taking Prochlorperazine?
Important warnings for Prochlorperazine include the risk of extrapyramidal symptoms (movement disorders), tardive dyskinesia, and neuroleptic malignant syndrome (NMS), which can be life-threatening. It should be used cautiously in people with a history of seizures, liver disease, or heart problems. Contraindications include hypersensitivity to the drug and conditions like severe CNS depression or coma.