PROCHLORPERAZINE

Indications & Dose:

• BY MOUTH

Adult

Tab:

Vertigo: 

5 mg three times daily Max: 30mg.

Nausea & Vomiting: 

prophylaxis,5-10mg 2-3 times daily. Treat-ment; 20mg than 10mg 2 hour later if required.

Minor mental disturbance:

15-20mg daily in divided doses then, increasing to max; 40mg daily.

Schizophernia: 

75- 100 mg daily.

Children: Vertigo & vomiting:

Over 10 kg 0.25/kg. two to three times daily.  Under 10kg not recommended.

Contraindications:

Severe toxic CNS depression, coma, subcortical brain damage, bone marrow depression, severe liver or cardiac disease, narrow angle glaucoma, pediatric surgery

Side Effects:

CNS: Agitation, anxiety, catatoniclike behavioral states, confusion, depression, drowsiness, EPS (pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia), 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

Eye/ENT: Blurred vision, cataracts, dry eyes, dry mouth, glaucoma, pigmentation 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

Cautions:

Precautions:

Children <5 yr, elderly, prolonged use, cardiovascular disease, epilepsy, hepatic or renal disease, glaucoma, prostatic hypertrophy, severe asthma, emphysema, hypocalcemia (increased susceptibility to dystonic reactions), thyrotoxicosis, tartrazine sensitivity

Pregnancy; majority of evidence indicates safety for both mother and fetus if used occasionally in low doses; excretion into breast milk should be expected; sedation is a possible effect in nursing infant

Interaction:

Drugs

Anticholinergies: Inhibited therapeutic response to antipsychotic; enhanced anticholinergic side effects

Antidepressants: Increased serum concentrations of some cyclic antidepressants

Attapulgite: Inhibition of phenothiazine absorption

Barbiturates: Reduced effect of antipsychotic

Beta Blockers: Enhanced effects of both drugs (interaction less likely with atenolol, nadolol)

Bromocriptine, lithium: Reduced effects of both drugs

Chloroquine, amodiaquine, pyrimethamine: Possible increased phenothiazine concentrations

Cigarettes: Possible enhanced metabolism of neuroleptic

Clonidine: Possible enhanced hypotensive effect

Epinephrine: Reversed pressor response to epinephrine

Ethanol: Enhanced ethanol effects

Guanethidine: Inhibited antihypertensive response to guanethidine

Indomethacin: Possible increased CNS effects, other NSAIDs less likely to have effect

Levodopa: Inhibited effect of levodopa on Parkinson’s disease

Narcotic analgesics: Excessive CNS depression, hypotension, respiratory depression

Orphenadrine: Reduced serum neuroleptic concentrations, excessive anticholinergic effects

Procarbazine: Increased sedation, EPS effects

SSRIs: Increased risk EPS effects

Trazadone: Possible increased risk hypotenstien

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: