Prochlorperazine

General

• Type: anti-psychotic and anti-emetic
• Dosage Forms: 5, 10
• Routes of Administration: IV, PO
• Common Trade Names: Compazine

Adult Dosing

Headache

• 10mg IV (slow push or in 1L IV NS)

Nausea/Vomiting

• 5-10mg PO or IV q6-8 hours
• Max: 40mg/day

Pediatric Dosing

nausea/vomiting, severe

2 yo and older, 9-14 kg

• 2.5mg PO q12-24 h; Max 7.5mg/day

2 yo and older, 14-18 kg

• 2.5mg PO q8-12 h; Max 10mg/day

2 yo and older, 18-39 kg

• 2.5mg PO q8 hr; Max 15mg/day

2 yo and older, >39 kg

• 5mg PO q6-8 h, Max: 20mg/day

Schizophrenia

2-5 yo

• 2.5 - 5mg PO q6-8 hr, Max 20mg/day

6-12 yo

• 2.5-5mg PO q6-8 hr, Max 25mg/day

Special Populations

• Pregnancy Rating: Pregnancy category C
• Lactation risk: Safety unknown
• Renal Dosing: not defined
• Hepatic Dosing: not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• tardive dyskinesia
• neuroleptic malignant syndrome
• blood dyscrasias
• agranulocytosis
• thrombocytopenic purpura
• orthostatic hypotension
• extrapyramidal symptoms
• cholestatic jaundice
• hepatotoxicity
• QT prolongation
• cardiac arrest
• seizures
• anaphylactoid reactions
• lupus erythematosus
• priapism
• heat stroke
• neonatal extrapyramidal symptoms (3rd trimester use)
• neonatal withdrawal symptoms (3rd trimester use)

Common

• drowsiness
• dizziness
• blurred vision
• xerostomia
• constipation
• urinary retention
• headache
• nasal congestion
• nausea
• menstrual irregularities
• amenorrhea
• weight gain
• hyperprolactinemia
• hyperglycemia
• hypoglycemia
• insomnia
• agitation
• sexual dysfunction
• photosensitivity
• impaired body temperature regulation

Pharmacology

• Half-life: 3-5 hrs (oral); 7 hrs (IV)
• Metabolism: liver extensively, GI tract
• Excretion: urine, bile/feces
• Mechanism of Action: selectively antagonizes dopamine D2 receptors

References

Authors

Jung-Eun Lim, Ross Donaldson, Neil Young, Daniel Ostermayer