Prochlorperazine(proe klor per’ a zeen)
Prochlorperazine
Compro
Prochlorperazine Edisylate
Prochlorperazine Maleate
Procomp
PREGNANCY CATEGORY C
Drug Classes
Antiemetic
Antipsychotic
Anxiolytic
Dopaminergic blocker
Phenothiazine (piperazine)
Therapeutic Actions
Mechanism of action not fully understood: Antipsychotics block postsynaptic dopamine receptors in the brain, but this may not be necessary and sufficient for antipsychotic activity; depresses the RAS, including the parts of the brain involved with wakefulness and emesis; anticholinergic, antihistaminic (H1), and alpha-adrenergic blocking activity also may contribute to some of its therapeutic (and adverse) actions.
Indications
Management of manifestations of psychotic disorders
Control of severe nausea and vomiting
Short-term treatment of nonpsychotic anxiety (not drug of choice)
Contraindications and Cautions
Contraindicated with hypersensitivity to phenothiazines, coma or severe CNS depression, bone marrow depression, blood dyscrasia, circulatory collapse, subcortical brain damage, Parkinson disease, liver damage, cerebral arteriosclerosis, coronary disease, congenital long-QT syndrome, severe hypotension or hypertension, history of cardiac arrhythmias.
Use cautiously with elderly patients, respiratory disorders, glaucoma, prostatic hypertrophy, epilepsy, breast cancer (elevations in prolactin may stimulate a prolactin-dependent tumor), thyrotoxicosis, peptic ulcer, decreased renal function, myelography within previous 24 hr or scheduled within 48 hr, exposure to heat or phosphorous insecticides, pregnancy, lactation, children younger than 12 yr, especially those with chickenpox, CNS infections (children are especially susceptible to dystonias that may confound the diagnosis of Reye syndrome).
Available Forms
Tablets—5, 10, 25 mg; suppositories—25 mg; injection—5 mg/mL
Dosages
Adults
Psychotic disturbances: Initially, 5–10 mg PO tid or qid. Gradually increase dosage every 2–3 days as needed up to 50–75 mg/day for mild or moderate disturbances, 100–150 mg/day for more severe disturbances. For immediate control of severely disturbed adults, 10–20 mg IM repeated every 2–4 hr (every hour for resistant cases); switch to oral therapy as soon as possible.
Antiemetic: For control of severe nausea and vomiting, 5–10 mg PO tid–qid; 15 mg (SR) on arising; 25 mg rectally bid; or 5–10 mg IM initially, repeated every 3–4 hr up to 40 mg/day.
Nausea, vomiting related to surgery: 5–10 mg IM 1–2 hr before anesthesia or during and after surgery (may repeat once in 30 min); 5–10 mg IV 15 min before anesthesia or during and after surgery (may repeat once); or as IV infusion, 20 mg/L of isotonic solution added to infusion 15–30 min before anesthesia.
Nonpsychotic anxiety: 5–10 mg PO tid or qid. Do not give more than 20 mg/day or for longer than 12 wk.
Pediatric patients
Do not use in pediatric surgery.
Less than 9 kg or younger than 2 yr: Generally not recommended.
Psychotic disturbances: 2–12 yr: 2.5 mg PO or rectally bid–tid. Do not give more than 10 mg on first day. Increase dosage according to patient response; total daily dose usually does not exceed 20 mg (2–5 yr) or 25 mg (6–12 yr).
Younger than 12 yr: 0.132 mg/kg by deep IM injection. Switch to oral dosage as soon as possible (usually after one dose).
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
