Action and Spectrum

Actions and Spectrum:

Actions:

• Anti-psychotic: prochlorperazine works by blocking the action of certain chemicals in the brain known as dopamine and serotonin, which are thought to be involved in the development of psychosis. This helps to reduce symptoms such as hallucinations, delusions, and disordered thinking.
• Antiemetic: prochlorperazine also blocks the action of another chemical in the brain called acetylcholine, which helps to reduce nausea and vomiting.

Spectrum:

• Schizophrenia: prochlorperazine is primarily used to treat symptoms of schizophrenia, such as hallucinations, delusions, and disordered thinking.
• Nausea and vomiting: prochlorperazine is also commonly used as an antiemetic to treat nausea and vomiting caused by various conditions such as chemotherapy, radiation therapy, and surgery.
• Other conditions: prochlorperazine may also be used to treat other conditions such as anxiety, insomnia, and irritable bowel syndrome. However, it is not typically the first-line treatment for these conditions and may only be used in specific cases.

Drug Interaction

Adverse Reaction

Frequency Defined

<1%

Dizziness

Insomnia

Anxiety

Agitation

Euphoria

Depression

Headache

Weakness

Cerebral edema

Tachycardia

Poikilothermia

Black Box Warning

Black Box Warning

The black box warning for prochlorperazine states that the drug has been associated with an increased risk of death in older adults with dementia-related psychosis.

Contraindication / Caution

Contraindication/Caution:

Contraindications:

• prochlorperazine should not be used in patients with known hypersensitivity to the drug or its components.
• It should also not be used in patients with severe central nervous system depression, comatose states, or blood dyscrasias (disorders of the blood cells).

Cautions:

• prochlorperazine should be used with caution in patients with a history of cardiovascular disease, hypertension, or diabetes.
• It should also be used with caution in patients with a history of glaucoma, urinary retention, or prostate hypertrophy.
• prochlorperazine may cause drowsiness and impair the ability to perform tasks requiring mental alertness, so patients should be advised to avoid activities that require mental alertness such as operating machinery or driving a car.
• It should be used with caution in elderly patients as they may be more sensitive to the drug’s side effects.
• Patients should be monitored for signs of tardive dyskinesia (a movement disorder) while taking prochlorperazine, especially if they are taking the drug for an extended period of time.

Pregnancy / Lactation

Pregnancy warnings:   

US FDA pregnancy category: C

Lactation:

Excreted into human milk is known.

Pregnancy Categories:     

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

prochlorperazine is a phenothiazine derivative that is used as an antiemetic and antipsychotic agent. It works by blocking dopamine receptors in the brain, which helps to reduce nausea and vomiting as well as symptoms of psychosis such as hallucinations and delusions.

Pharmacodynamics:

prochlorperazine acts as a dopamine antagonist, specifically blocking the D2 receptors in the brain. This leads to a decrease in the activity of the dopamine neurotransmitter, which is thought to be involved in the regulation of nausea and vomiting as well as the symptoms of psychosis.

Pharmacokinetics:

Absorption

It is well-absorbed from the gastrointestinal tract and reaches peak plasma concentrations within 2-4 hours after oral administration.

Distribution

prochlorperazine is highly protein-bound in the bloodstream and is distributed to the brain and other body tissues. It also crosses the blood-brain barrier, which is important for its efficacy in treating symptoms of schizophrenia and other psychiatric conditions.

Metabolism

It is metabolized in the liver by the cytochrome P450 enzyme system.

Elimination and excretion

The half-life of prochlorperazine is approximately 12-24 hours, which means that it takes 12-24 hours for half of the medication to be eliminated from the body. Prochlorperazine is primarily eliminated through the kidneys and feces.

Adminstartion

Administration:

The recommended dosage and administration of prochlorperazine will vary depending on the condition being treated and the individual patient. It is important to follow the instructions provided by your healthcare provider and read the medication label carefully before administering the drug.

For the treatment of schizophrenia, the typical starting dose is 5-10 mg orally 2-3 times per day. The dosage may be increased as needed but should not exceed 40 mg per day.

For the treatment of nausea and vomiting, the typical starting dose is 5-10 mg orally 3-4 times per day. The dosage may be increased as needed but should not exceed 40 mg per day.

For the treatment of anxiety, the typical starting dose is 5-10 mg orally 2-3 times per day. The dosage may be increased as needed but should not exceed 40 mg per day.

When administering prochlorperazine in the form of a suppository, it should be inserted into the rectum as directed by your healthcare provider.

When administering prochlorperazine in the form of an injectable solution, it should be administered intramuscularly or intravenously as directed by your healthcare provider.

It is important to note that prochlorperazine may cause drowsiness, so it is important to avoid driving or operating heavy machinery while taking this medication. It is also important to avoid alcohol while taking prochlorperazine as it may increase the risk of drowsiness and other side effects.

Patient Information Leaflet

Patient information leaflet

Generic Name: prochlorperazine

Why do we use prochlorperazine?

prochlorperazine is used to treat a variety of conditions, including:

1. Schizophrenia: prochlorperazine is used to reduce symptoms of schizophrenia, such as hallucinations, delusions, and disordered thinking.
2. Nausea and vomiting: prochlorperazine is used to reduce nausea and vomiting caused by conditions such as cancer chemotherapy, radiation therapy, and surgery.
3. Anxiety: prochlorperazine is used to reduce symptoms of anxiety, such as nervousness, agitation, and restlessness.
4. Vertigo: prochlorperazine is used to reduce symptoms of vertigo, such as dizziness, spinning sensations, and loss of balance.
5. Insomnia: prochlorperazine is also used in some cases to reduce symptoms of insomnia and to help people fall asleep.

prochlorperazine works by blocking the action of certain chemicals in the brain that can cause symptoms of psychosis, anxiety, and nausea.