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Prochlorperazine: Brands, Price & Uses in Bangladesh
Prochlorperazine is a phenothiazine antipsychotic/antiemetic agent approved and commonly used for the following indications and more.
About Prochlorperazine
Indications of Prochlorperazine
Prochlorperazine is a phenothiazine antipsychotic/antiemetic agent approved and commonly used for the following indications, listed by strength of evidence:
Established / FDA-approved uses
- Control of severe nausea and vomiting – including nausea and vomiting associated with surgery, radiotherapy, chemotherapy, and other causes of severe emesis.
- Management of psychotic disorders, including schizophrenia, at higher doses under close medical supervision.
- Short-term treatment of non-psychotic (generalized) anxiety – Prochlorperazine is not a first-line agent for anxiety and is generally limited to a maximum dose of 20 mg/day for no longer than 12 weeks because of the risk of tardive dyskinesia.
Additional guideline-supported / commonly reported use
- Vertigo associated with Meniere's disease and other vestibular disorders (reported in regional labeling; use per treating physician's judgement).
Prochlorperazine is not approved for the treatment of dementia-related psychosis in elderly patients (see Warnings).
Dosage & Administration of Prochlorperazine
Severe Nausea and Vomiting (Adults)
| Route | Typical Dose |
|---|---|
| Oral | 5–10 mg three to four times daily; doses above 40 mg/day are reserved for resistant cases and should be used only under close medical supervision |
| Intramuscular/Intravenous | 5–10 mg by deep IM injection, repeated every 3–4 hours as needed (per product labeling); slow IV administration may be used in a monitored setting |
Psychotic Disorders (Schizophrenia) — Adults
| Severity | Typical Dose |
|---|---|
| Mild-to-moderate, outpatient | 5–10 mg orally three to four times daily |
| Moderate-to-severe, hospitalized | Starting 10 mg three to four times daily, gradually increased; usual effective range 50–150 mg/day under specialist supervision |
Non-Psychotic Anxiety (Adults)
5 mg three to four times daily; maximum 20 mg/day, for no longer than 12 weeks, due to risk of tardive dyskinesia.
Pediatric Dosing (Nausea/Vomiting, weight-based, oral) — Children ≥2 years and ≥9 kg
| Body Weight | Typical Dose | Maximum Daily Dose |
|---|---|---|
| 9–13 kg | 2.5 mg once or twice daily | 7.5 mg/day |
| 14–17 kg | 2.5 mg two or three times daily | 10 mg/day |
| 18–39 kg | 2.5 mg three times daily or 5 mg twice daily | 15 mg/day |
Prochlorperazine is not recommended for children under 2 years of age or weighing less than 9 kg, and should not be used for pediatric surgery.
Elderly Patients
Use the lowest effective dose with gradual titration and close monitoring; elderly patients are more sensitive to hypotensive, anticholinergic, and extrapyramidal effects (see Precautions and Warnings).
General Administration Notes
Take Prochlorperazine exactly as prescribed by a physician. Do not increase, decrease, or stop the dose, and do not share this medicine with others, without medical advice. Oral tablets may be taken with or without food.
Side Effects of Prochlorperazine
Side effects of Prochlorperazine range from common and mild to rare but serious.
Common
- Drowsiness and sedation
- Dizziness
- Dry mouth, blurred vision, constipation (anticholinergic effects)
- Orthostatic hypotension
- Skin reactions, photosensitivity
Extrapyramidal Symptoms (more common in younger patients and at higher doses)
- Acute dystonia (muscle spasms of face, neck, back, tongue protrusion)
- Akathisia (restlessness, inability to sit still)
- Drug-induced parkinsonism (tremor, rigidity, shuffling gait)
- Tardive dyskinesia – potentially irreversible involuntary movements of the face, tongue, and body that can develop with long-term use; risk increases with cumulative dose and duration of treatment.
Rare but Serious
- Neuroleptic malignant syndrome (NMS) – a rare, potentially fatal reaction with fever, muscle rigidity, altered consciousness, and autonomic instability; requires immediate discontinuation and emergency medical care.
- Blood dyscrasias (leukopenia, agranulocytosis, thrombocytopenia)
- Cholestatic jaundice
- Cardiac arrhythmias and QT prolongation
- Seizures
Patients should seek prompt medical attention for fever, unexplained muscle stiffness, sore throat, unusual bruising/bleeding, or yellowing of the skin/eyes while taking Prochlorperazine.
Contraindications of Prochlorperazine
Prochlorperazine is contraindicated in the following situations:
- Known hypersensitivity to Prochlorperazine or to other phenothiazines.
- Comatose states or severe CNS depression.
- Presence of large amounts of other CNS depressants (alcohol, barbiturates, opioids) in the body.
- Pre-existing bone marrow suppression or severe blood dyscrasias.
- Pediatric surgery, and use in children under 2 years of age or under approximately 9 kg body weight.
Frequently Asked Questions about Prochlorperazine
What is Prochlorperazine used for?
Prochlorperazine is used to control severe nausea and vomiting (such as after surgery, radiotherapy, or chemotherapy), to manage psychotic disorders such as schizophrenia at higher doses, and, less commonly, for short-term treatment of non-psychotic anxiety.
Can I take Prochlorperazine during pregnancy?
Prochlorperazine should be used during pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the fetus. Use late in pregnancy has been linked to extrapyramidal and withdrawal symptoms in newborns. Always consult your physician before using Prochlorperazine during pregnancy.
What are the most serious side effects of Prochlorperazine?
The most serious side effects of Prochlorperazine include neuroleptic malignant syndrome (fever, severe muscle stiffness, confusion), tardive dyskinesia (potentially irreversible involuntary movements with long-term use), blood cell disorders, and abnormal heart rhythms. Elderly patients with dementia-related psychosis treated with Prochlorperazine or similar drugs have an increased risk of death; Prochlorperazine is not approved for this use. Seek medical attention immediately if you develop fever, severe muscle stiffness, or uncontrollable movements.
Can Prochlorperazine be given to children?
Prochlorperazine can be used in children 2 years of age and older, mainly for severe nausea and vomiting, using weight-based dosing prescribed by a physician. It is not recommended for children under 2 years of age or under about 9 kg body weight, and must not be used for pediatric surgery, as children are more prone to certain movement-related side effects.
Is it safe to drink alcohol while taking Prochlorperazine?
No. Alcohol should be avoided while taking Prochlorperazine, as it can increase drowsiness and central nervous system depression and add to the sedative effects of the medicine.
What should I do if I miss a dose or take too much Prochlorperazine?
If you miss a dose of Prochlorperazine, take it as soon as you remember unless it is nearly time for the next dose; do not double the dose. If you suspect an overdose of Prochlorperazine, this is a medical emergency — seek immediate medical attention or contact emergency services/poison control right away.
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.