Brand name:

Prochlorperazine

Pronounced: pro-klor-PEAR-ah-zine

Why is Prochlorperazine prescribed?

Prochlorperazine is used to control severe nausea and vomiting. It is also used to treat symptoms of the mental disorder schizophrenia, and is occasionally prescribed for anxiety.

Most important fact about Prochlorperazine

Prochlorperazine may cause tardive dyskinesia--involuntary muscle spasms and twitches in the face and body. This condition may be permanent. It appears to be most common among the elderly, especially women. Ask your doctor for information about this possible risk.

How should you take Prochlorperazine?

Never take more prochlorperazine than prescribed. It can increase the risk of serious side effects.

If you are using the suppository form of prochlorperazine and find it is too soft to insert, you can chill it in the refrigerator for about 30 minutes or run cold water over it before removing the wrapper.

To insert a suppository, first remove the wrapper and moisten the suppository with cold water. Then lie down on your side and use a finger to push the suppository well up into the rectum.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

--Storage instructions...

Store at room temperature. Protect from heat and light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Prochlorperazine.

• More common side effects may include:
  Blurred vision, dizziness, drowsiness, jaundice, low blood pressure, menstrual irregularities, neuroleptic malignant syndrome (see "Special warnings about this medication"), skin reactions

Why should this drug not be prescribed?

Do not take prochlorperazine if you are sensitive to or have ever had an allergic reaction to prochlorperazine or other phenothiazine drugs such as Thorazine, Prolixin, Triavil, Mellaril, or Stelazine.

Prochlorperazine should not be given to children who are undergoing surgery.

Special warnings about Prochlorperazine

Never take large amounts of alcohol, barbiturates, or narcotics when taking prochlorperazine. Serious problems can result.

Prochlorperazine should be used with caution if you are being treated for a brain tumor, intestinal blockage, heart disease, breast cancer, seizures, glaucoma, or an abnormal bone marrow or blood condition such as leukemia. Also use caution if you're exposed to pesticides or extreme heat.

If you suddenly stop taking prochlorperazine, you may experience a change in appetite, dizziness, nausea, vomiting, and tremors. Therapy should be discontinued only under a doctor's supervision.

Due to its ability to prevent vomiting, prochlorperazine can mask symptoms of an overdose of other drugs. It could also mask symptoms of brain tumor, intestinal blockage, and the neurological condition known as Reye's syndrome.

Prochlorperazine should be used cautiously in children suffering from dehydration or an acute illness such as chickenpox, measles, or other infection. The drug should be avoided altogether in children and adolescents who have symptoms that could indicate Reye's syndrome, including persistent or recurrent vomiting, listlessness, irritability, combativeness, and disorientation.

Prochlorperazine can cause a potentially fatal group of symptoms called Neuroleptic Malignant Syndrome (NMS). Symptoms include extremely high body temperature, rigid muscles, mental changes, irregular pulse or blood pressure, rapid heartbeat, excessive sweating, and changes in heart rhythm. Alert your doctor immediately if these symptoms develop. Prochlorperazine therapy will need to be discontinued.

This drug may impair your ability to drive a car or operate potentially dangerous machinery. Do not participate in any activities that require full alertness if you are unsure about your ability.

While taking prochlorperazine, try to stay out of the sun. Use sun block and wear protective clothing. Your eyes may become more sensitive to sunlight, too, so keep sunglasses handy.

Prochlorperazine interferes with your ability to shed extra heat. Be cautious in hot weather.

People taking prochlorperazine for a prolonged period should see their doctor for regular evaluations, since side effects can get worse over time.

Prochlorperazine may cause false-positive phenylketonuria (PKU) tests.

Possible food and drug interactions when taking Prochlorperazine

If prochlorperazine is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining prochlorperazine with the following:

Antiseizure drugs such as Dilantin and Tegretol
Anticoagulants such as Coumadin
Guanethidine (Ismelin)
Lithium (Lithobid, Eskalith)
Narcotic painkillers such as Demerol and Tylenol with Codeine
Other central nervous system depressants such as Xanax, Valium, Seconal, Halcion
Propranolol (Inderal)
Thiazide diuretics such as Dyazide

Special information if you are pregnant or breastfeeding

Prochlorperazine is not usually recommended for pregnant women. However, your doctor may prescribe it for severe nausea and vomiting if the potential benefits of the drug outweigh the potential risks. Prochlorperazine appears in breast milk and may affect a nursing infant. If this drug is essential to your health, your doctor may recommend that you stop breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

To Control Severe Nausea and Vomiting

Tablets: The usual dosage is one 5-milligram or 10-milligram tablet 3 or 4 times a day.

"Spansule" Capsules: The usual starting dose is one 15-milligram capsule on getting out of bed or one 10-milligram capsule every 12 hours.

The usual rectal dosage (suppository) is 25 milligrams, taken 2 times a day.

For Non-psychotic Anxiety

Tablets: The usual dose is 5 milligrams, taken 3 or 4 times a day.

"Spansule" capsule: The usual starting dose is one 15-milligram capsule on getting up or one 10-milligram capsule every 12 hours.

Treatment should not continue for longer than 12 weeks, and daily doses should not exceed 20 milligrams.

Relatively Mild Schizophrenia

The usual dose is 5 or 10 milligrams, taken 3 or 4 times daily.

Moderate to Severe Schizophrenia

Dosages usually start at 10 milligrams, taken 3 or 4 times a day. If needed, dosage may be gradually increased; 50 to 75 milligrams daily has been helpful for some people.

More Severe Schizophrenia

Dosages may range from 100 to 150 milligrams per day.

CHILDREN

Children under 2 years of age or weighing less than 20 pounds should not be given prochlorperazine. If a child becomes restless or excited after taking prochlorperazine, do not give the child another dose.

For Severe Nausea and Vomiting

An oral or rectal dose of Prochlorperazine is usually not needed for more than 1 day.

Children 20 to 29 pounds: The usual dose is 2-1/2 milligrams 1 or 2 times daily. Total daily amount should not exceed 7.5 milligrams.

Children 30 to 39 pounds: The usual dose is 2-1/2 milligrams 2 or 3 times daily. Total daily amount should not exceed 10 milligrams.

Children 40 to 85 pounds: The usual dose is 2-1/2 milligrams 3 times daily, or 5 milligrams 2 times daily. Total daily amount should not exceed 15 milligrams.

For Schizophrenia

Children 2 to 5 years old: The starting oral or rectal dose is 2-1/2 milligrams 2 or 3 times daily. Do not exceed 10 milligrams the first day and 20 milligrams thereafter.

Children 6 to 12 years old: The starting oral or rectal dose is 2-1/2 milligrams 2 or 3 times daily. Do not exceed 10 milligrams the first day and 25 milligrams thereafter.

OLDER ADULTS

In general, older people take lower dosages of prochlorperazine. Because they may develop low blood pressure while taking the drug, the doctor should monitor them closely. Older people (especially women) may be more susceptible to tardive dyskinesia--a possibly permanent condition. Tardive dyskinesia causes involuntary muscle spasms and twitches in the face and body. Consult your doctor for more information about these potential risks.

Overdosage

An overdose of prochlorperazine can be fatal. If you suspect an overdose, seek medical help immediately.

• Symptoms of prochlorperazine overdose may include:
  Agitation, coma, convulsions, dry mouth, extreme sleepiness, fever, intestinal blockage, irregular heart rate, restlessness