|•||Management of nausea and vomiting.|
|•||Treatment of psychoses.|
|•||Treatment of anxiety.|
Individualize dosage. Subcutaneous administration is not advised because of local irritation.
Adults: PO 5 mg 3 to 4 times daily. Do not exceed 20 mg/day or give for more than 12 wk.
Adults: IM Start with 10 to 20 mg for immediate control of schizophrenic patients with severe symptomatology; if necessary, repeat initial dose every 2 to 4 h to gain control of patient. More than 3 or 4 doses are seldom necessary. If IM therapy is needed for a prolonged period, give 10 to 20 mg every 4 to 6 h.
Mild conditions: PO 5 to 10 mg 3 or 4 times daily.
Moderate to severe conditions: PO 10 mg 3 to 4 times daily, increasing dosage gradually (every 2 or 3 days) until symptoms are controlled or adverse reactions become bothersome. Some patients respond satisfactorily on 50 to 75 mg/day; in more severe disturbances, the optimum dosage is usually 100 to 150 mg/day.
Children 2 to 12 yr of age: PO 2.5 mg 2 or 3 times daily. Do not exceed 10 mg the first day.
Children 2 to 5 yr of age: PO Do not exceed 20 mg/day.
Children 6 to 12 yr of age: PO Do not exceed 25 mg/day. IM For children younger than 12 yr of age, calculate each dose on the basis of 0.03 mg/kg given by deep IM injection.
Nausea and Vomiting
Adults: PO 5 or 10 mg tablet 3 to 4 times daily. PR 25 mg twice daily. IM 5 to 10 mg. May repeat every 3 to 4 h. Do not exceed 40 mg/day. IV 2.5 to 10 mg by slow IV or infusion at a rate not to exceed 5 mg/min (single dose not to exceed 10 mg; max, 40 mg/day).
Children: Adjust according to patient response and severity of symptoms.
Children 18 to 38.5 kg: PO 2.5 mg 3 times daily or 5 mg twice daily; do not exceed 15 mg/day. IM 0.03 mg/kg given by deep IM injection.
Children 13.6 to 17.6 kg: PO 2.5 mg given 2 to 3 times daily; do not exceed 10 mg/day. IM 0.03 mg/kg given by deep IM injection.
Children 9 to 13 kg: PO 2.5 mg given once or twice daily; do not exceed 7.5 mg/day. IM 0.03 mg/kg given by deep IM injection.
Nausea and Vomiting (Surgery)
Adults: IM 5 to 10 mg 1 to 2 h prior to induction of anesthesia (may repeat once in 30 min) or to control acute symptoms during and after surgery (may repeat once).
Adults: IV injection or infusion 5 to 10 mg 15 to 30 min before induction of anesthesia or to control acute symptoms during or after surgery. Repeat once if necessary. Rate of administration should not exceed 5 mg/min and a single dose should not exceed 10 mg.
|•||Administer tablets without regard to meals. Administer with food if GI upset occurs.|
|•||Administer IM dose by slow, deep injection into outer quadrant of buttock.|
|•||Administer IV dose by slow IV injection or infusion at rate not exceeding 5 mg/mL. Injection may be administered undiluted or diluted in isotonic solution (eg, normal saline, D5W). Do not administer as bolus.|
|•||Injection is not for intradermal or subcutaneous administration.|
|•||Do not administer injection if particulate matter or marked discoloration are noted. A slight yellowish discoloration is normal and will not alter potency.|
|•||Do not mix injection with other drugs in syringe.|
|•||If injection is spilled on skin or clothing, rinse area immediately with water to prevent contact dermatitis.|
Effects apparently related to dopamine receptor blocking in CNS. Antiemetic activity may be caused by direct inhibition on medullary chemoreceptor trigger zone.
Coma or severely depressed states; allergy to any phenothiazine; presence of large amounts of other CNS depressants; children younger than 2 yr of age or less than 20 lb; surgery in children
CV: Orthostatic hypotension; hypertension; tachycardia; bradycardia, syncope; cardiac arrest; circulatory collapse; ECG changes.
CNS: Lightheadedness; faintness; dizziness; pseudoparkinsonism; dystonia; dyskinesia; motor restlessness; oculogyric crises; opisthotonos; hyperreflexia; tardive dyskinesia; drowsiness; headache; weakness; tremor; fatigue; slurring of speech; insomnia; vertigo; abnormalities of CSF proteins; paradoxical excitement or exacerbation of psychotic symptoms; catatonic-like states; paranoid reactions; lethargy; seizures; hyperactivity; nocturnal confusion; bizarre dreams.
DERM: Photosensitivity; skin pigmentation; dry skin; pruritus; exfoliative dermatitis; urticarial rash; maculopapular hypersensitivity reaction; seborrhea; eczema.
EENT: Pigmentary retinopathy; glaucoma; photophobia; blurred vision; mydriasis; glaucoma; dry mouth or throat; nasal congestion.
GI: Nausea; vomiting; dyspepsia, adynamic ileus (which may result in death); constipation.
GU: Urinary hesitancy or retention; impotence, sexual dysfunction; menstrual irregularities; priapism; breast enlargement; galactorrhea.
HEMA: Agranulocytosis; eosinophilia; leukopenia; hemolytic anemia; thrombocytopenic purpura; pancytopenia; aplastic anemia.
METAB: Hyperglycemia; hypoglycemia; increased cholesterol levels.
RESP: Laryngospasm; bronchospasm; dyspnea.
OTHER: Increases in appetite and weight; polydipsia; increased prolactin levels; heat stroke.
Alcohol or other CNS depressants
May result in increased CNS depression and may precipitate dystonic reactions.
May reduce therapeutic effects of prochlorperazine and worsen anticholinergic effects.
Frequency and severity of neuromuscular excitation and hypotension may be increased.
May result in increased plasma levels of beta-blocker and prochlorperazine.
The risk of life-threatening cardiac arrhythmias, including torsades de pointes, may be increased.
Hypotensive action of guanethidine may be inhibited.
Possibility of seizure may be increased when subarachnoid metrizamide injection is used.
Plasma levels of prochlorperazine may be elevated, increasing the risk of adverse reactions.
Do not mix prochlorperazine injection with other agents in syringe. Do not dilute with any diluent containing parabens as preservative.
Therapeutic Classification: antiemetics, antipsychotics
Pharmacologic Classification: phenothiazines
Absorption: Absorption from tablet is variable; may be better with oral liquid formulations. Well absorbed after IM administration.
Distribution: Widely distributed, high concentrations in the CNS. Crosses the placenta and probably enters breast milk.
Metabolism/Excretion: Highly metabolized by the liver and GI mucosa. Converted to some compounds with antipsychotic activity.
|ORAL||30-40 MINUTE||UNKNOWN||3-4 HOUR|
|ORAL-ER||30-40 MINUTE||UNKNOWN||10-12 HOUR|
|RECTUM||60 MINUTE||UNKNOWN||3-4 HOUR|
|IM||10-20 MINUTE||10-30 MINUTE||3-4 HOUR|
|IV||RAPID(MIN)||10-30 MINUTE||3-4 HOUR|