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Prochlorperazine (Compazine)

Category:

  • Miscellaneous

Description:

  • Antiemetic, antipsychotic

Indications:

  • Severe nausea and vomiting

  • Psychotic disorders

Contraindications:

  • Severe toxic CNS depression, coma, subcortical brain damage, bone marrow depression

  • Severe liver or cardiac disease, narrow-angle glaucoma, pediatric surgery

Precautions:

  • Pregnancy category C; evidence indicates safety in low doses; expect sedation in nursing infants

  • Children <5 years, prolonged use, cardiovascular disease, epilepsy

  • Hepatic or renal disease, glaucoma, prostatic hypertrophy, severe asthma

  • Emphysema, hypocalcemia, thyrotoxicosis, tartrazine sensitivity

Adverse Reactions (Side Effects):

  • CNS: agitation, anxiety, catatonic-like behavioral states, confusion, depression, drowsiness, EPS, euphoria, exacerbation of psychotic symptoms including hallucinations, headache, heat or cold intolerance, insomnia, lethargy, neuroleptic malignant syndrome, restlessness, seizures, vertigo

  • CV: ECG changes, hypertension, hypotension, tachycardia

  • EENT: blurred vision, cataracts, dry eyes, dry mouth, glaucoma, pigmentaion of retina or cornea, retinopathy

  • GI: anorexia, constipation, diarrhea, dyspepsia, hypersalivation, nausea, vomiting

  • GU: priapism, urinary retention

  • HEME: agranulocytosis, anemia, aplastic anemia, hemolytic anemia, leukocytosis, transient leukopenia

  • METAB: breast engorgement, gynecomastia, hyperglycemia, hyperprolactinemia, hypoglycemia, hyponatremia, impotence, increased libido, lactation, mastalgia, menstrual irregularities

  • RESP: bronchospasm, increased depth of respiration, laryngospasm

  • SKIN: diaphoresis, loss of hair, maculopapular and acneiform skin reactions, photosensitivity

Dosage:

Administered orally, intramuscularly, intravenously, rectally

  • Adult:            

    • Antiemetic: PO 5-10mg 3-4 times daily, usual max 40mg daily; PO extended release 10mg 2 times daily or 15mg once daily; IM 5-10mg every 3-4 hours, usual max 40mg daily; IV 2.5-10mg every 3-4 hours, max 10mg per dose, 40 mg/day; PR 25mg 2 times daily

    • Psychosis: PO 5-10mg 3-4 times daily, increase dose as needed, max 150mg daily; IM 10-20mg every 4 hours as needed, convert to PO as soon as possible

  • Child:            

    • Antiemetic: PO/PR 9-14kg: 2.5mg every 12 –24 hours, max 7.5mg daily; 14-18kg: 2.5mg every 8 hours or 5mg every 12 hours, max 15mg daily; IM 0.1-0.5 mg/kg/dose, convert to PO as soon as possible

    • Psychosis: PO/PR 2-12 years: 2.5mg 2-3 times daily, increase dose as needed, max 20mg daily; 2-5 years: 25mg daily; IM 6-12 years: 0.13 mg/kg/dose, convert to PO as soon as possible

Drug interactions:

·        Levodopa: inhibited effect of levodopa on Parkinson’s disease

·        Indomethacin: possible increased CNS side effects, other NSAIDs less likely to have effect

·        Narcotic analgesics: excessive CNS depression, hypotension, respiratory depression

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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