Indications:

Chlorpromazine is indicated in Psychoses, Nausea and vomiting, Psychoses, Intractable hiccup, Psychoses.

Pharmacology:

Chlorpromazine is a neuroleptic that acts by blocking the postsynaptic dopamine receptor in the mesolimbic dopaminergic system and inhibits the release of hypothalamic and hypophyseal hormones. It has antiemetic, serotonin-blocking, and weak antihistaminic properties and slight ganglion-blocking activity.

Dosage (breakdown or, not) :

Adult:

 Schizophrenia, Psychotic Disorders PO: 30-75 mg/day divided q6-12hr initially; maintenance: usually 200 mg/day (up to 800 mg/day in some patients; some patients may require 1-2 g/day) IV/IM: 25 mg initially, followed PRN with 25-50 mg after 1-4 hours, then increased to maximum of 400 mg q4-6hr until patient is controlled; usual dosage 300-800 mg/day Nausea & Vomiting PO: 10-25 mg q4-6hr PRN IV/IM: 25-50 mg q4-6hr PRN Preoperative Apprehension 25-50 mg PO 2-3 hours before surgery 12.5-25 mg IM 1-2 hours before surgery Intraoperative Sedation 12.5 IM q30min or 2 mg IV q2min; total dose not to exceed 25 mg Intractable Hiccups 25-50 mg PO q6-8hr; if hiccups persist after 2-3 days of oral therapy, administer 25-50 mg IM q3-4hr; if symptoms persist, administer 25-50 mg by slow IV infusion with patient lying flat in bed; monitor BP Acute Intermittent Porphyria 25-50 mg PO q6-8hr Elderly: Initially, 1/3-½ the normal adult dose.

Child: 

Behavioral Disorders, Hyperactivity >6 months: 50-100 mg/day PO/IM; 200 mg/day or more may be necessary for older hospitalized patients; for outpatients, may administer 0.55 mg/kg q4-6hr PRN Nausea & Vomiting >6 months: 0.5-1 mg/kg PO/IM q6-8hr PRN Preoperative Apprehension >6 months: 0.55 mg/kg PO/IM 1-2 hours before surgery <6 months: Safety and efficacy not established

Interaction:

Potentiation of anticholinergic effects of antiparkinson agents and TCAs may lead to an anticholinergic crisis. Additive orthostatic hypotensive effect in combination with MAOIs. Reverses antihypertensive effect of guanethidine, methyldopa and clonidine. Potentially Fatal: Additive depressant effect with sedatives, hypnotics, antihistamines, general anaesthetics, opiates and alcohol.

Contraindication:

Do not use in patients with known hypersensitivity to phenothiazines. Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).

Side Effects: 

Tardive dyskinesia (on long-term therapy). Involuntary movements of extremities may also occur. Dry mouth, constipation, urinary retention, mydriasis, agitation, insomnia, depression and convulsions; postural hypotension, ECG changes. Allergic skin reaction, amenorrhoea, gynaecomastia, weight gain. Hyperglycaemia and raised serum cholesterol.

Pregnancy: 

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Precautions & Warnings: 

Parkinson's disease; CV disease; renal or hepatic impairment; cerebrovascular and respiratoty disease; jaundice; DM; hypothyroidism; paralytic ileus; prostatic hyperplasia or urinary retention; epilepsy or history of seizures; myasthenia gravis; pregnancy; elderly (especially with dementia), and debilitated patients. Avoid direct sunlight.

Storage Conditions:

Store at 15-30°C.