Prochlorperazine

DEA Class;  Rx

Common Brand Names; Compazine, Compazine Spansules, prochlorperazine edisylate, prochlorperazine mesylate

Documented hypersensitivity to phenothiazines

Coma, severe CNS depression, concurrent use of large amounts of CNS depressants, poorly controlled seizure disorder, subcortical brain damage

Postoperative management of nausea/vomiting following pediatric surgery

Children <2 years or weighing <9 kg

• Insomnia
• Restlessness (immediate restlessness or agitation may be treated with diphenhydramine 25 mg IV push)
• Dizziness
• Anxiety
• Euphoria
• Agitation
• Depression
• Weakness
• Headache
• Cerebral edema
• Poikilothermia
• Orthostatic hypotension (after IM injection)
• Tachycardia
• ECG changes
• Anorexia
• Dyspepsia
• Constipation
• Diarrhea
• Ileus
• Blood dyscrasia
• Galactorrhea
• Gynecomastia
• Ejaculatory disorder
• Lens opacities (with prolonged use)
• Photosensitivity
• Pruritus
• Frequency Not Defined
• Akathisia
• Sedation
• Anticholinergic effects
• Weight gain
• Oligomenorrhea or amenorrhea
• Erectile dysfunction
• Extrapyramidal symptoms (muscle stiffness, dystonia, parkinsonism, tardive dyskinesia)
• Neuroleptic malignant syndrome (infrequent but serious)
• Seizure
• Decreased gag reflex
• Confusion
• Hypotension
• Hypertension

Avoid using in children with suspected Reye syndrome

Use caution in evere hypertension, severe cardiovascular disease

Use with caution in glaucoma, prostatic hypertrophy, stenosing peptic ulcer disease, history of neuroleptic malignant syndrome, Parkinson disease, hypocalcemia, renal/hepatic impairment, history of severe reactions to insulin or electroconvulsive therapy, history of seizures, asthma, respiratory tract infections, cardiovascular disease, myelosuppression

Blood dyscrasias including neutropenia, agranulocytosis, and leukopenia reported with use; discontinue therapy at first sign of blood dyscrasias

Risk of extrapyramidal symptoms, neuroleptic malignant syndrome, hypotension (may be particularly severe in patients with pheochromocytoma or mitral insufficiency)

Esophageal dysmotility/aspiration may occur; use with caution in patients at risk of pneumonia

Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia

May alter cardiac conduction; life-threatening arrhythmias reported with therapeutic doses

May cause anticholinergic effects (constipation, xerostomia, urinary retention, blurred vision); use caution in patients with decreased gastrointestinal motility, paralytic ileus, urinary retention, BPH, xerostomia, visual problems

May cause pigmentary retinopathy and lenticular and corneal deposits, especially in prolonged therapy

May cause sedation and impair ability to perform tasks which require mental alertness, including operating heavy machinery

Use associated with increased prolactin levels

In case of severe hypotension, use norepinephrine or phenylepinephrine; do not use epinephrine or dopamine

Do not crush extended-release product

Pregnancy category: C

Lactation: Phenothiazines may be excreted in breast milk; do not nurse