Prochlorperazine is an antipsychotic medication primarily used to treat and control a variety of symptoms, including severe nausea and vomiting, anxiety, agitation, and schizophrenia. This drug belongs to the phenothiazine class, exerting its therapeutic effects by blocking dopamine receptors and serotonin receptors in the brain.
Clinically, prochlorperazine is commonly used as an antiemetic, especially effective in severe nausea and vomiting following chemotherapy or surgery. Additionally, it can alleviate unstable emotions and hyperexcitability caused by neurological or psychiatric conditions, but must be used strictly according to a physician’s instructions to avoid serious side effects.
The generic name of this medication is prochlorperazine. Common brand names in Taiwan and Hong Kong include "Compazine" and "Stemetil." Different formulations (such as tablets, injections, patches) may vary by manufacturer, but the active ingredient remains prochlorperazine.
Prochlorperazine is classified as a phenothiazine antipsychotic and antiemetic. Its primary mechanism of action involves antagonizing dopamine D2 receptors, while also possessing antihistamine and anticholinergic properties, allowing it to relieve both nausea and psychiatric symptoms.
The main indications include:
1. Severe nausea and vomiting post radiotherapy, chemotherapy, or surgery
2. Acute manic episodes in schizophrenia and bipolar disorder
3. Anxiety or tension before and after surgery
4. Nausea and motion sickness caused by migraines.
Physicians may expand the use based on clinical judgment, but this should be based on risk-benefit assessment. Off-label uses should be avoided to reduce unnecessary risk of side effects.
Mild side effects include dry mouth, blurred vision, drowsiness, muscle stiffness, and orthostatic hypotension. These symptoms often appear early in treatment, and most patients will gradually adapt. If symptoms are severe, notify a healthcare professional immediately.
Serious side effects include: extrapyramidal symptoms (such as involuntary movements), QT prolongation, neuroleptic malignant syndrome. Immediate medical attention is required if symptoms such as high fever, muscle rigidity, or irregular heartbeat occur.
Contraindications include: glaucoma, history of epilepsy, severe hepatic or renal impairment, and allergy to phenothiazines. Pregnant and breastfeeding women should evaluate risks before use, as it may cause muscle rigidity or other issues in the fetus or newborn.
This medication may impair judgment and reaction time. Avoid operating machinery or driving while on medication. Long-term use may lead to tardive dyskinesia, which can persist for weeks or years after discontinuation.
Using with monoamine oxidase inhibitors (MAOIs) may trigger hypertensive crises; a minimum of 14 days should pass between discontinuing MAOIs and starting prochlorperazine. Combining with anticoagulants (such as warfarin) may enhance anticoagulant effects, increasing bleeding risk.
Oral formulations typically start at 5-10 mg/day, divided into multiple doses; severe nausea and vomiting may require 20-30 mg/day. Injectable forms are used for emergencies and should be administered by healthcare professionals. Patches should be applied to the skin and replaced every 7 days.
It is recommended to take the medication after meals or with food to reduce gastrointestinal discomfort. If using other medications concurrently, inform the physician of all prescriptions and over-the-counter drugs to avoid interactions.
If a dose is missed, take it as soon as possible; if less than 4 hours remain before the next dose, skip the missed dose and resume the normal schedule. Do not double doses to make up for missed ones to prevent toxicity.
Overdose may cause coma, respiratory depression, and cardiac arrhythmias. If overdose is suspected, seek immediate medical attention and bring the medication container for reference. Symptoms of poisoning include muscle rigidity, dilated pupils, and disorientation.
Emergency measures include gastric lavage, activated charcoal, and ECG monitoring. Long-term overdose can lead to permanent neurological damage; therefore, do not adjust doses without medical supervision.
Q: If I forget to take prochlorperazine on time, what should I do?
A: If a dose is missed, take it as soon as possible. If it is close to the next scheduled dose, skip the missed dose and continue with the regular schedule. Do not take double doses to compensate for missed ones to avoid increased side effects. Setting reminders or using a pill organizer can help with memory.
Q: Since prochlorperazine can cause drowsiness, is it safe to drive or operate machinery while on medication?
A: This medication may cause dizziness or drowsiness, affecting reaction times. Avoid driving or operating dangerous machinery during initial treatment until you know how the drug affects you. If side effects persist, consult your doctor for dose adjustment.
Q: Does long-term use of prochlorperazine lead to dependence or addiction?
A: This drug does not cause physical dependence, but long-term use may induce drug-induced movement disorders. If discontinuing, follow medical advice to gradually reduce the dose to prevent rebound symptoms. Do not extend the treatment period without medical evaluation.
Q: Can I take other painkillers or cold medicines simultaneously with prochlorperazine?
A: Combining with certain painkillers (such as aspirin, ibuprofen) or cold medicines containing antihistamines may increase drowsiness or affect the nervous system. Inform your doctor of all medications you are taking, including OTC drugs, to avoid interactions.
Q: Can prochlorperazine affect liver or kidney function? Do I need regular tests during treatment?
A: Long-term or high-dose use may slightly impact liver function, but severe liver damage is rare. Patients with liver or kidney issues should have dose adjustments and regular blood tests. If symptoms like jaundice or dark urine occur, stop medication and seek medical attention.
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