7 Prochlorperazine Side Effects and How to Manage Them

Prochlorperazine is a medication used to treat severe nausea and vomiting from surgery or cancer treatments. It’s also used to treat health conditions such as schizophrenia. You can receive it as an oral tablet, shot, or rectal suppository.

Prochlorperazine works by blocking a chemical in the brain called dopamine. Dopamine is responsible for several of our bodies’ important functions, such as the regulation of movement and mood. But if dopamine levels are too high, it can make you feel nauseated.

This medication isn’t selective for dopamine, though. Prochlorperazine also targets other chemical messengers that cause nausea — such as histamine and acetylcholine. This helps calm nausea, but it also makes side effects more likely to happen.

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Prochlorperazine’s side effects can vary, with some being mild and others more severe. As with any other medication, it’s important to understand its possible side effects and how to manage them.

Prochlorperazine side effects at a glance

Some people take prochlorperazine for a short period of time. Others take it chronically. But anyone can develop side effects no matter how long they’ve been taking it. 

Common prochlorperazine side effects include:

• Dizziness

• Drowsiness

• Blurry vision

• Constipation

• Low blood pressure

• Changes to your menstrual cycle

 Rare, but potentially serious side effects include:

• Changes in blood cell counts

• Uncontrolled muscle movements

• Neuroleptic malignant syndrome

If you only take doses of prochlorperazine every once in a while, side effects may appear after each dose. But if you take it more routinely, side effects may gradually get better with time. Below, we’ll go over seven notable prochlorperazine side effects and how to manage them.

1. Drowsiness

Prochlorperazine can make you feel sleepy, especially during the first few days of taking it. It’s a good idea to avoid tasks that require a lot of attention until you know how the medication affects you.

Drowsiness often gets better after starting prochlorperazine. In the meantime, adopting a routine that promotes good sleep hygiene can be beneficial. Integrating regular exercise into your day and maintaining a diet rich in nutritious foods can also help boost energy levels. Be mindful that alcohol and other medications, such as opioids and benzodiazepines, can make drowsiness worse.

If drowsiness doesn’t improve or interferes with your daily life, reach out to your healthcare provider. They may adjust how much prochlorperazine you take with every dose or when you take it. If the drowsiness is severe, they may suggest alternative treatments.

2. Blurry vision

Blurry vision is a side effect that may occur with prochlorperazine. It can happen shortly after starting the medication or after taking it for a while.

Blurry vision can make it hard to judge distances, see clearly, or notice small details. This is problematic for tasks such as reading or driving. For the safety of yourself and others, avoid driving or performing other high-alert tasks if you develop blurry vision.

If blurry vision doesn’t improve after a couple days, or if it gets worse at any point, contact your healthcare provider for help. Be sure to talk to them before starting any new medications, too. Some medications, such as scopolamine (Transderm Scop), can make blurry vision worse if combined with prochlorperazine.

3. Low blood pressure and dizziness

Prochlorperazine can sometimes lower your blood pressure, especially when standing up quickly from a seated or resting position. This may make you feel dizzy or like you’re going to faint.

To prevent dizziness, take your time when standing up from a seated or lying down position. This gives your body a chance to adjust to the positional change. It also lowers the risk of a sudden drop in blood pressure.

Staying well hydrated also helps. Drinking water shortly before standing up can help avoid sudden blood pressure changes, too. Clinical studies have reported that drinking about 2 cups of water about 5 minutes before getting up helps prevent a sudden drop in blood pressure.

4. Uncontrolled muscle movements

Some people taking prochlorperazine develop uncontrolled muscle movements called extrapyramidal symptoms (EPS). In most cases, it occurs within 2 to 5 days of starting the medication. EPS can affect many different muscle groups, including in the back, limbs, and face.

A rare but serious type of EPS that can occur is tardive dyskinesia (TD). It’s more likely in adults older than 65 years old and people who have been taking prochlorperazine for months to years.

TD most commonly affects muscles of the face, mouth, or jaw. These muscle movements are repetitive, involuntary, and difficult to control. Common TD symptoms include:

• Grimacing, or frowning

• Lip-smacking

• Tongue movements

• Excessive blinking

If you begin to experience uncontrolled muscle movements, contact your healthcare provider immediately.

5. Changes to your menstrual cycle

Women taking prochlorperazine may notice changes in their menstrual cycle. These include irregular periods or changes in menstrual flow. In some cases, it can even cause your periods to stop altogether — a condition known as amenorrhea.

Amenorrhea isn’t necessarily harmful on its own. But it can be a sign of high prolactin levels. Too much of this hormone can lead to unexpected breast milk production and sexual health issues, such as lower sexual desire or performance. If left unchecked, high prolactin may lead to more serious health problems.

If you experience side effects like these, it’s important to talk with your healthcare provider. They may suggest a prolactin test to determine if it’s the cause of your symptoms.

6. Changes in blood cell counts

Prochlorperazine can lower the number of white blood cells in your body. With fewer white blood cells, your body may have a harder time fighting off infections. Because of this, it’s important to be aware of common signs and symptoms of an infection:

• Fever

• Sore throat

• Chills

• Cough

• Feeling unusually tired

Maintaining good hygiene is key to staying healthy. Make sure to wash your hands often with soap and water. If you don’t have access to soap and water, alcohol-based hand sanitizers are a good backup. Try to keep your distance from people who are sick to lower your chance of infections.

Vaccines are another way to protect yourself against infections. Check with your healthcare provider to make sure your vaccinations are up to date.

7. Neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a very rare condition that’s possible while taking prochlorperazine. Symptoms usually develop within hours or days after starting the medication. But it can develop up to a month later too. If not treated early, NMS can lead to kidney or respiratory failure. It can be life threatening.

Possible symptoms of NMS include:

• Fever

• Stiff or rigid muscles

• Confusion

• Uncontrollable changes in heart rate, blood pressure, and breathing

NMS is more common after taking large doses of prochlorperazine or after increasing your dosage too quickly. Other risk factors are dehydration, exposure to heat, and brain conditions like dementia.

To reduce the risk of NMS, it’s important to take the medication as prescribed and to stay well hydrated. Be sure to go to all your follow-up appointments, especially after starting or increasing your dose.

When should you contact your healthcare provider about prochlorperazine side effects?

Serious side effects with prochlorperazine aren’t common. But knowing which symptoms to look for is key.

If you notice uncontrollable movements in your face or body, call your healthcare provider right away. These movements could be a sign of TD. Early treatment increases the odds of managing it effectively.

Prochlorperazine can also make it more likely to catch an infection. If you experience symptoms such as fever, chills, or a cough, it could mean that you have an infection. If this happens, let your healthcare provider know.

A sudden fever, muscle stiffness, and confusion could indicate NMS. The same goes for difficulty breathing and an uneven heartbeat. This is considered a medical emergency, and you should seek help as soon as possible. If caught and treated in a hospital early, NMS symptoms typically get better within a few weeks.

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Written by:

Vanessa Carranza, PharmD

Vanessa Carranza, PharmD, is a pharmacist who has dedicated her career to the advancement of medical education for healthcare providers, patients, and caregivers, most notably in the oncology space.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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