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prochlorperazine
Compazine, PMS Prochlorperazine†, Prorazin†, Stemetil†

prochlorperazine edisylate
Compazine, Compazine Syrup

prochlorperazine maleate
Compazine, Compazine Spansule, PMS Prochlorperazine†, Prorazin†, Stemetil†

Pregnancy Risk Category C

How supplied
prochlorperazine

Tablets:
5 mg, 10 mg
Injection:
5 mg/ml
Suppositories:
2.5 mg, 5 mg, 25 mg
prochlorperazine edisylate

Syrup:
5 mg/5 ml
Injection:
5 mg/ml
prochlorperazine maleate

Tablets:
5 mg, 10 mg, 25 mg
Capsules (extended-release):
10 mg, 15 mg, 30 mg

Action
Acts on the chemoreceptor trigger zone to inhibit nausea and vomiting; in larger doses, it partially depresses vomiting center.

Indications & dosage
Preoperative nausea control--

Adults:
5 to 10 mg I.M. 1 to 2 hours before induction of anesthesia; repeat once in 30 minutes, if needed. Or, 5 to 10 mg I.V. 15 to 30 minutes before induction of anesthesia; repeat once, if needed.
Severe nausea and vomiting--

Adults:
5 to 10 mg P.O., t.i.d. or q.i.d.; 15 mg sustained-release form P.O. on rising; 10 mg sustained-release form P.O. q 12 hours; 25 mg P.R., b.i.d.; or 5 to 10 mg I.M. repeated q 3 to 4 hours, p.r.n. Maximum I.M. dose is 40 mg daily. Or, 2.5 to 10 mg I.V. at a rate not to exceed 5 mg/
minute.
Children weighing 18 to 39 kg (40 to 86 lb):
2.5 mg P.O. or P.R., t.i.d.; or 5 mg P.O. or P.R., b.i.d. Maximum dose is 15 mg daily. Or, 0.132 mg/kg by deep I.M. injection. Control usually is obtained with one dose.
Children weighing 14 to 17 kg (31 to 37 lb):
2.5 mg P.O. or P.R., b.i.d. or t.i.d. Maximum dose is 10 mg daily. Or, 0.132 mg/kg by deep I.M. injection. Control usually is obtained with one dose.
Children weighing 9 to 13 kg (20 to 29 lb):
2.5 mg P.O. or P.R. once daily or b.i.d. Maximum dose is 7.5 mg daily. Or, 0.132 mg/kg by deep I.M. injection. Control usually is obtained with one dose.
To manage symptoms of psychotic disorders--

Adults:
5 to 10 mg P.O., t.i.d. or q.i.d.
Children ages 2 to 12:
2.5 mg P.O. or P.R., b.i.d. or t.i.d. Don't exceed 10 mg on day 1. Increase dosage gradually to recommended maximum (if needed). In children ages 2 to 5, maximum daily dose is 25 mg. In children ages 6 to 10, maximum daily dose is 25 mg.
To manage symptoms of severe psychosis--

Adults:
10 to 20 mg I.M. repeated in 1 to 4 hours, if needed. Rarely, patients may receive 10 to 20 mg q 4 to 6 hours. Institute oral therapy after symptoms are controlled.
Children ages 2 to 12:
0.13 mg/kg I.M.
Nonpsychotic anxiety--

Adults:
5 to 10 mg by deep I.M. injection q 3 to 4 hours, not to exceed 20 mg daily and not to be given for more than 12 weeks; or 5 to 10 mg P.O., t.i.d. or q.i.d. Or, 15 mg extended-release capsule once daily or 10 mg extended-release capsule q 12 hours.

Adverse reactions
CNS:
extrapyramidal reactions, sedation, pseudoparkinsonism, EEG changes, dizziness.
CV:
orthostatic hypotension, tachycardia, ECG changes.
EENT:
ocular changes, blurred vision.
GI:
dry mouth, constipation, increased appetite, weight gain.
GU:
urine retention, dark urine, menstrual irregularities, gynecomastia, inhibited ejaculation.
Hematologic:
transient leukopenia, agranulocytosis.
Hepatic:
cholestatic jaundice, elevated liver enzyme levels.
Skin:
mild photosensitivity, allergic reactions, exfoliative dermatitis.
Other:
hyperprolactinemia.

Interactions
Drug-drug.
Antacids: inhibited absorption of oral phenothiazines. Separate antacid and phenothiazine doses by at least 2 hours.
Anticholinergics, including antidepressants and antiparkinsonians:
increased anticholinergic activity and aggravated parkinsonian symptoms. Use together cautiously.
Barbiturates:
may decrease phenothiazine effect. Monitor patient for decreased antiemetic effect.

Effects on diagnostic tests
Drug causes false-positive results for urinary porphyrins, urobilinogen, amylase, and 5-hydroxyindoleacetic acid; it also causes false-positive urine pregnancy results in tests using human chorionic gonadotropin.

Contraindications
Contraindicated in patients with hypersensitivity to phenothiazines and in those with CNS depression, including coma; also contraindicated during pediatric surgery; when using spinal or epidural anesthetic, adrenergic blockers, or ethanol; and in children under age 2.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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