Generic Name

Prochlorperazine Maleate

Precaution

Extrapyramidal syndrome, hypotension, epilepsy, impaired hepatic, renal, CV, cerebrovascular or respiratory function, glaucoma. May impair ability to drive or perform tasks requiring mental alertness or physical coordination. Parenteral use in children is not recommended. History of jaundice, parkinsonism, diabetes mellitus, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia or urinary retention. Regular eye examinations are recommended in patients on long-term treatment. Lactation: Phenothiazines may be excreted in breast milk; do not nurse

Indication

Vertigo, Psychoses, Nausea and vomiting, Severe anxiety disorders

Contra Indication

CNS depression, comatose patients. Bone marrow depression, phaechromocytoma, prolactin-dependent tumours, hypersensitivity. Childn <2 yr. Pregnancy and lactation.

Dose

N/A

Side Effect

<1% Insomnia,Restlessness,Dizziness,Anxiety,Euphoria,Agitation,Depression,Weakness,Headache,Cerebral edema,Poikilothermia,Tachycardia,ECG changes,Anorexia,Dyspepsia,Constipation,Diarrhea,Ileus,Blood dyscrasia,Galactorrhea,Gynecomastia,Ejaculatory disorder,Lens opacities (with prolonged use),Photosensitivity,Pruritus Frequency Not Defined Akathisia,Sedation,Anticholinergic effects,Weight gain,Oligomenorrhea or amenorrhea,Erectile dysfunction,Extrapyramidal symptoms (muscle stiffness, dystonia, parkinsonism, tardive dyskinesia),Neuroleptic malignant syndrome (infrequent but serious),Seizure,Decreased gag reflex,Confusion,Hypotension,Hypertension,Leukopenia,Agranulocytosis,Cholestatic jaundice,Photosensitivity reaction,Priapism,Hepatotoxicity Potentially Fatal: Bone-marrow suppression. Cardiac arrhythmias or aspiration.

Pregnancy Category

Mode of Action

Prochlorperazine blocks both postsynaptic dopamine receptors as well as the medullary chemo receptor trigger zone. It depresses hypothalamic and hypophyseal hormone release and posssesses alpha-adrenergic and anticholinergic inhibitory activity.

Interaction

Additive anticholinergic effects with antihistamines, tricyclic antidepressants and drugs used in parkinsonism. May reduce the antihypertensive effect of guanethidine and other adrenergic neurone blockers. May also increase risk of arrhythmias when used with drugs that prolong QT interval. Potentially Fatal: Potentiation of other CNS depressants including alcohol, sedatives, hypnotics, barbiturates, opioids, antihistamines and general anaesthetics.

Pregnancy Category Note

Pregnancy category: C Lactation: Phenothiazines may be excreted in breast milk; do not nurse

Adult Dose

Oral Prophylaxis of nausea and vomitting Adult: As maleate : 5-10 mg bid/tid. Nausea and vomiting Adult: As maleate : 20 mg, further doses are given if needed. Recommended buccal dose: As maleate: 3-6 mg bid. Psychoses Adult: As maleate : 12.5 mg bid for 7 days, adjusted gradually to 75-100 mg daily according to response. Usual maintenance dose: 25-50 mg daily. Adjunct in severe anxiety disorders Adult: As maleate: 5-10 mg, up to 3-4 times daily. Vertigo Adult: As maleate : 15-30 mg daily, given in divided doses. May reduce gradually to 5-10 mg daily. Recommended buccal dose: 3-6 mg bid.

Child Dose

Oral Psychoses Child: 1-5 yr: 1.25-2.5 mg; 5-12 yr: 2.5-5 mg. May be given up to tid, if necessary.

Renal Dose

N/A

Administration

May be taken with or without food.