$Unique_ID{BRK03082} $Pretitle{} $Title{chlorpromazine} $Subject{ Ormazine Hauck Sonazine Cord Thorazine Smith Kline French Spansules Thor-Prom Major Phenothiazine tranquilize chlorpromazine hydrochlorid ental illness emotional psychosis manic manic-depressive illness behavioral problems nerve transmission chemicals brain tetanus porphyria hiccups anxiety nausea vomiting} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. chlorpromazine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) chlorpromazine hydrochloride (various manufacturers) Ormazine (Hauck) Sonazine (Cord) Thorazine (Smith Kline & French) Thorazine Spansules (Smith Kline & French) Thor-Prom (Major) TYPE OF DRUG Phenothiazine tranquilizer INGREDIENT chlorpromazine hydrochloride DOSAGE FORMS Tablets (10 mg, 25 mg, 50 mg, 100 mg, and 200 mg) Sustained-release capsules (30 mg, 75 mg, 150 mg, 200 mg, and 300 mg) Oral concentrate (30 mg per ml and 100 mg per ml) Oral syrup (10 mg per 5-ml spoonful) Suppositories (25 mg and 100 mg) STORAGE The tablet and capsule forms of this drug should be stored at room temperature in tightly closed, light-resistant containers. The oral concentrate, oral syrup, and suppository forms of this drug should be stored in the refrigerator in tightly closed, light-resistant containers. If the oral concentrate or syrup turns to a slight yellow color, the medicine is still effective and can be used. However, if the oral concentrate or syrup changes color markedly or has particles floating in it, it should not be used; instead, it should be discarded down the sink. Chlorpromazine should never be frozen. USES Chlorpromazine is prescribed to treat the symptoms of certain types of mental illness, such as emotional symptoms of psychosis, the manic phase of manic-depressive illness, and severe behavioral problems in children. This medication is thought to relieve the symptoms of mental illness by blocking certain chemicals involved with nerve transmission in the brain. Chlorpromazine may also be used to treat tetanus, porphyria, uncontrollable hiccups, anxiety before surgery, and nausea and vomiting (this medication works at the vomiting center in the brain to relieve nausea and vomiting). TREATMENT To avoid stomach irritation, take the tablet or capsule forms of this medication with a meal or with a glass of water or milk (unless your doctor directs you to do otherwise). The sustained-release capsules should be taken whole; do not crush, break, or open them prior to swallowing. Breaking the capsule would release the medication all at once--defeating the purpose of the extended-release capsules. Measure the oral syrup carefully with a specially designed 5-ml measuring spoon. An ordinary kitchen teaspoon is not accurate enough. The oral concentrate form of this medication should be measured carefully with the dropper provided, then added to four ounces (one-half cup) or more of water, milk, or a carbonated beverage or to applesauce or pudding immediately prior to administration. Be careful that the serving size is not more than the patient is willing or able to drink or eat; otherwise, the full dose may not be consumed. To prevent possible loss of effectiveness, the medication should not be diluted in tea, coffee, or apple juice. To use the suppository form of this medication, remove the foil wrapper and moisten the suppository with water (if the suppository is too soft to insert, refrigerate it for half an hour or run cold water over it before removing the wrapper). Lie on your left side with your right knee bent. Push the suppository into the rectum, pointed end first. Lie still for a few minutes. Try to avoid having a bowel movement for at least an hour. If you miss a dose of this medication, take the missed dose as soon as possible, then return to your regular schedule. If it is almost time for the next dose, however, skip the one you missed and return to your regular schedule. Do not double the dose (unless your doctor directs you to do so). Antacids and antidiarrheal medicines may decrease the absorption of this medication from the gastrointestinal tract. Therefore, at least one hour should separate doses of one of these medicines and chlorpromazine. The full effects of this medication for the control of emotional or mental symptoms may not become apparent for two weeks after you start to take it. SIDE EFFECTS Minor. Blurred vision, constipation, decreased sweating, diarrhea, dizziness, drooling, drowsiness, dry mouth, fatigue, jitteriness, menstrual irregularities, nasal congestion, restlessness, tremors, vomiting, or weight gain. As your body adjusts to the medication, these side effects should disappear. This medication can cause increased sensitivity to sunlight. It is, therefore, important to avoid prolonged exposure to sunlight or sunlamps. Wear protective clothing, and use an effective sunscreen. Chlorpromazine can also cause discoloration of the urine to red, pink, or red-brown. This is a harmless effect. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). Chew sugarless gum or suck on ice chips or a piece of hard candy to reduce mouth dryness. To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about breast enlargement (in both sexes); chest pain; convulsions; darkened skin; difficulty in swallowing or breathing; fainting; fever; impotence; involuntary movements of the face, mouth, jaw, or tongue; palpitations; rash; sleep disorders; sore throat; uncoordinated movements; unusual bleeding or bruising; visual disturbances; or yellowing of the eyes or skin. INTERACTIONS Chlorpromazine interacts with several types of drugs: 1. It can cause extreme drowsiness when combined with alcohol or other central nervous system depressants (such as barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, and pain medications) or with tricyclic antidepressants. 2. Chlorpromazine can decrease the effectiveness of amphetamines, guanethidine, anticonvulsants, and levodopa. 3. The side effects of cyclophosphamide, epinephrine, monoamine oxidase (MAO) inhibitors, phenytoin, and tricyclic antidepressants may be increased by this medication. 4. Chlorpromazine can increase the absorption of propranolol, which can increase the risks of side effects. 5. Lithium may increase the side effects and decrease the effectiveness of this medication. Before starting to take chlorpromazine, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to chlorpromazine or any other phenothiazine tranquilizers (such as fluphenazine, mesoridazine, perphenazine, prochlorperazine, promazine, thioridazine, and trifluoperazine) or to loxapine. * Tell your doctor if you have a history of alcoholism, or if you now have or ever had blood disease, bone marrow disease, brain disease, breast cancer, blockage in the urinary or digestive tract, drug-induced depression, epilepsy, high or low blood pressure, diabetes mellitus, glaucoma, heart or circulatory disease, liver disease, lung disease, Parkinson's disease, peptic ulcers, or an enlarged prostate gland. * Tell your doctor about any recent exposure to a pesticide or an insecticide. Chlorpromazine may increase the side effects from the exposure. * To prevent oversedation, avoid drinking alcoholic beverages while taking this medication. * If this drug makes you dizzy or drowsy, avoid any activity that requires alertness. Be careful on stairs, and avoid getting up suddenly from a lying or sitting position. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Some of the side effects caused by this drug can be prevented by taking an antiparkinsonism drug. Discuss this with your doctor. * This medication can decrease sweating and heat release from the body. You should, therefore, avoid becoming overheated by strenuous exercise in hot weather and should avoid taking hot baths, showers, and saunas. * Do not stop taking this medication suddenly. If the drug is stopped abruptly, you may experience nausea, vomiting, stomach upset, headache, increased heart rate, insomnia, tremors, or a worsening of your condition. Your doctor may want to reduce the dosage gradually. * If you are planning to have a myelogram or any other procedure in which dye will be injected into your spinal cord, tell your doctor that you are taking this medication. * Avoid spilling the oral concentrate or oral syrup forms of this medication on your skin or clothing; it may cause redness and irritation of the skin. * While you are being treated with this medication, do not take any over-the-counter (nonprescription) medications for weight control or for cough, cold, allergy, asthma, or sinus problems without first checking with your doctor. The combination of these medications with chlorpromazine may cause high blood pressure. * Be sure to tell your doctor if you are pregnant. Small amounts of this medication cross the placenta. Although there are reports of safe use of this drug during pregnancy, there are also reports of liver disease and tremors in newborn infants whose mothers received this medication close to term. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this medication pass into breast milk and may effect in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.