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Chlorpromazine Hydrochloride: Brands, Price & Uses in Bangladesh
Chlorpromazine Hydrochloride is a first-generation (typical) phenothiazine antipsychotic.
About Chlorpromazine Hydrochloride
Indications of Chlorpromazine Hydrochloride
Chlorpromazine Hydrochloride is a first-generation (typical) phenothiazine antipsychotic. Its evidence-based uses include:
- Established/FDA-approved uses:
- Management of manifestations of psychotic disorders, including schizophrenia.
- Control of nausea and vomiting.
- Relief of restlessness and apprehension before surgery.
- Treatment of intractable hiccups.
- Management of acute intermittent porphyria.
- Management of severe behavioral problems in children (combativeness, explosive hyperexcitable behavior), and for short-term treatment of hyperactive children who show excessive motor activity.
- Presurgical apprehension and as an adjunct in the treatment of tetanus.
- Guideline-supported / adjunct uses: Adjunctive treatment of manic episodes of bipolar disorder (as add-on to a mood stabilizer, since Chlorpromazine Hydrochloride alone is not a first-line agent for bipolar maintenance).
- Off-label use (not FDA-approved, used in clinical practice): Adjunct for acute agitation in emergency settings when other options are unsuitable.
Chlorpromazine Hydrochloride is not approved for treatment of dementia-related psychosis in elderly patients (see Precautions and Warnings for the boxed warning).
Dosage & Administration of Chlorpromazine Hydrochloride
Adults
| Indication | Typical Dose |
|---|---|
| Psychotic disorders (outpatient) | 10 mg 3–4 times daily, or 25 mg 2–3 times daily; increase gradually as needed and tolerated |
| Psychotic disorders (hospitalized/severe) | 25 mg 3 times daily initially, increasing every 1–2 days up to 400 mg/day or more in resistant cases (some patients have required up to 800–2000 mg/day under close monitoring) |
| Nausea and vomiting | 10–25 mg orally every 4–6 hours as needed; 25–50 mg intramuscularly every 3–4 hours if oral route not feasible |
| Intractable hiccups | 25–50 mg 3–4 times daily |
| Preoperative apprehension | 25–50 mg 2–3 hours before surgery |
Children (6 months–12 years)
Approximately 0.55 mg/kg body weight orally every 4–6 hours as needed, or rectally/intramuscularly per specialist guidance. Maximum recommended daily dose is generally 40 mg for children under 5 years and 75 mg for children aged 5–12 years, unless otherwise directed by a physician. Chlorpromazine Hydrochloride is not recommended in children under 6 months of age except when potentially life-saving.
Elderly Patients
Start at approximately half the usual adult dose with slower dose titration, due to increased sensitivity to sedative and hypotensive effects.
Administration
May be taken with food or milk to reduce gastrointestinal irritation. Oral concentrate must be diluted before use. Intramuscular injection should be given deep into a large muscle mass; avoid subcutaneous injection due to tissue irritation. Dosage of Chlorpromazine Hydrochloride must always be individualized by the treating physician.
Side Effects of Chlorpromazine Hydrochloride
Common side effects of Chlorpromazine Hydrochloride include:
- Sedation and drowsiness
- Orthostatic hypotension
- Extrapyramidal symptoms (dystonia, akathisia, pseudo-parkinsonism)
- Anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention)
- Weight gain
- Photosensitivity (advise sun protection)
Less common but clinically important effects include tardive dyskinesia (risk increases with duration of therapy), neuroleptic malignant syndrome (rare but potentially life-threatening — see Precautions and Warnings), agranulocytosis and other blood dyscrasias (rare), cholestatic jaundice, QT interval prolongation and cardiac arrhythmias, and corneal/lenticular pigment deposits with long-term high-dose therapy.
Contraindications of Chlorpromazine Hydrochloride
Chlorpromazine Hydrochloride is contraindicated in patients with:
- Known hypersensitivity to Chlorpromazine Hydrochloride or other phenothiazine derivatives.
- Severe CNS depression or comatose states from any cause.
- Circulatory collapse.
- Existing blood dyscrasias or bone marrow suppression.
Frequently Asked Questions about Chlorpromazine Hydrochloride
What is Chlorpromazine Hydrochloride used for?
Chlorpromazine Hydrochloride is used to treat schizophrenia and other psychotic disorders, severe nausea and vomiting, intractable hiccups, preoperative apprehension, and as an adjunct for certain manic episodes and severe behavioral problems in children.
Can Chlorpromazine Hydrochloride be used in elderly patients with dementia?
No. Elderly patients with dementia-related psychosis treated with antipsychotic drugs, including Chlorpromazine Hydrochloride, have an increased risk of death. Chlorpromazine Hydrochloride is not approved for this use.
Is Chlorpromazine Hydrochloride safe during pregnancy?
Chlorpromazine Hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as third-trimester exposure has been associated with extrapyramidal and withdrawal symptoms in newborns. Always consult a physician before use during pregnancy.
What are the common side effects of Chlorpromazine Hydrochloride?
Common side effects of Chlorpromazine Hydrochloride include sedation, orthostatic hypotension (dizziness on standing), extrapyramidal symptoms such as tremor or stiffness, dry mouth, constipation, weight gain, and increased sensitivity to sunlight.
Can I stop taking Chlorpromazine Hydrochloride suddenly?
Do not stop Chlorpromazine Hydrochloride abruptly without consulting your physician, as sudden discontinuation may cause withdrawal-like symptoms or relapse of underlying symptoms; dose changes should be made gradually under medical supervision.
What should I do if I miss a dose or take too much Chlorpromazine Hydrochloride?
If you miss a dose of Chlorpromazine Hydrochloride, take it as soon as you remember unless it is close to the next dose. If overdose is suspected, seek immediate medical attention or contact emergency services/poison control, as overdose can cause severe drowsiness, low blood pressure, and abnormal heart rhythms.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.