Prochlorperazine is used to treat severe nausea and vomiting. It's also used to improve mood, thoughts, and behaviors for people with schizophrenia and anxiety. It's not a first-choice medication because it can cause serious side effects, such as extreme sleepiness, falls, and uncontrolled muscle movements. Prochlorperazine comes as a tablet that's taken by mouth, typically 3 to 4 times daily. The brand name version of prochlorperazine (Compazine) is no longer available.
Severe nausea and vomiting
Schizophrenia
Generalized anxiety disorder (GAD)
Prochlorperazine a typical antipsychotic and an antiemetic (anti-nausea) medication. It mainly works by blocking dopamine, a chemical made by your brain that affects many parts of the body. When prochlorperazine blocks dopamine in the brain, it not only controls nausea and vomiting, but also lowers your anxiety and helps with symptoms of schizophrenia, such as hallucinations and delusions.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Phenothiazines can sometimes cause serious unwanted effects. Tardive dyskinesia or tardive dystonia (muscle movement disorders) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia or tardive dystonia include worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, body, arms, or legs. Another possible serious unwanted effect is the neuroleptic malignant syndrome (NMS). Signs and symptoms of NMS include severe muscle stiffness, fever, fast heartbeat, difficult breathing, increased sweating, and loss of bladder control. You and your doctor should discuss the good this medicine will do as well as the risks of taking it.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Rare
Symptoms of neuroleptic malignant syndrome
Confusion (severe) or coma
difficult or fast breathing
fast heartbeat
high or low (irregular) blood pressure
increased sweating
loss of bladder control
muscle stiffness (severe)
trembling or shaking
trouble in speaking or swallowing
Check with your doctor immediately if any of the following side effects occur:
More common
Inability to move eyes
increased blinking or spasms of eyelid
lip smacking or puckering
muscle spasms of face, neck, body, arms, or legs causing unusual postures or unusual expressions on face
puffing of cheeks
rapid or worm-like movements of tongue
sticking out of tongue
tic-like or twitching movements
trouble in breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled movements of arms or legs
uncontrolled twisting movements of neck, trunk, arms, or leg
Rare
Irregular or slow heart rate
recurrent fainting
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Blurred vision, change in color vision, or difficulty in seeing at night
fainting
loss of balance control
mask-like face
restlessness or need to keep moving
shuffling walk
stiffness of arms or legs
trembling and shaking of hands and fingers
Less common
Difficulty in urinating
skin rash
sunburn (severe)
Rare
Abdominal or stomach pains
aching muscles and joints
agitation, bizarre dreams, excitement, or trouble in sleeping
bleeding or bruising (unusual
clumsiness
confusion (mild)
constipation (severe)
convulsions (seizures)
dark urine
fever and chills
headaches
hot, dry skin or lack of sweating
itchy skin (severe)
muscle weakness
pain in joints
prolonged, painful, inappropriate erection of the penis
redness of hands
shivering
skin discoloration (tan or blue-gray)
sore throat and fever
sores in mouth
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Phenothiazines may cause your urine to be dark. In most cases, this is not a sign of a serious problem. However, if your urine does become dark, discuss it with your doctor.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Changes in menstrual period
decreased sexual ability
increased sensitivity of eyes to light
rough or “fuzzy” tongue
secretion of milk (unusual)
swelling or pain in breasts
watering of mouth
weight gain (unusual)
After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this time, check with your doctor if you notice dizziness, nausea and vomiting, stomach pain, trembling of the fingers and hands, or any of the following signs of tardive dyskinesia or tardive dystonia:
Inability to move eyes
lip smacking or puckering
muscle spasms of face, neck, body, arms, or legs, causing unusual body positions or unusual expressions on face
puffing of cheeks
rapid or worm-like movements of tongue
sticking out of tongue
tic-like or twitching movements
trouble in breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled twisting or other movements of neck, trunk, arms, or legs
Although not all of the side effects listed above have been reported for all of the phenothiazines, they have been reported for at least one of them. However, since all of the phenothiazines are very similar, any of the above side effects may occur with any of these medicines.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available as a generic medication
Available as an oral tablet or suppository for treating nausea and vomiting
Typically starts working in 30 minutes and effects last up to 4 hours
Many serious and sometimes possibly permanent side effects, such as uncontrolled muscle movements
Can't be used in children under 2 years old or under 20 pounds due to higher risk of serious side effects
Not recommended for use in pregnancy or during breastfeeding
Prochlorperazine can make you drowsy and affect your ability to focus and concentrate. Avoid driving or performing any activity that requires a lot of attention until you know how this medication affects you. Let your provider know if this medication makes you too sleepy.
Prochlorperazine can make you feel dizzy, which can raise your risk for falls. If you need to sit up or stand up, hold on to something stable so that you don't fall. Make sure to remove any clutter or tripping hazards at home so it's safer for you to walk around. Let your provider know if you feel very dizzy from this medication and they can talk with you about other alternatives that might work well for you.
Stop prochlorperazine and contact your healthcare provider right away if you begin to have unusual, uncontrolled, or repetitive movements of the eyes, tongue, face, arm, or legs. These might be signs of tardive dyskinesia, which can become permanent.
Discuss with your healthcare provider if you want to stop taking prochlorperazine. Don't suddenly stop this medication, especially if you have been on it for a long time. If you do, you might experience symptoms such as nausea, vomiting, dizziness, and tremors.
Let your provider know if you have glaucoma, a condition where the pressure inside the eye is high. Prochlorperazine might widen your pupils and raise the pressure inside your eyes, which can lead to blindness.
Prochlorperazine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Older adults with dementia-related psychosis
People over the age of 65 who also have dementia sometimes have some of the symptoms of schizophrenia, like hallucinations and delusions. This is called dementia-related psychosis, and it should not be treated with prochlorperazine. If prochlorperazine is used for dementia-related psychosis, it can cause death. Let your provider know if you or your loved one has dementia before starting prochlorperazine.
Risk factors: Older adults | Female and 65 years or older | Higher than recommended doses of prochlorperazine | Taking prochlorperazine for a long time
Prochlorperazine can cause uncontrolled and possibly permanent muscle movements in the tongue, face, mouth, lips, neck, hands, arms, legs, and feet (tardive dyskinesia). To lower your risk of tardive dyskinesia, take the lowest dose possible for the shortest period of time for your symptoms. Stop taking prochlorperazine and talk to your provider right away if you notice any unusual movements you can't control.
Risk factors: Younger adults | Children who have an active infection or are dehydrated | Males | Higher than recommended doses of prochlorperazine
Prochlorperazine can cause other uncontrolled muscle movements in addition to tardive dyskinesia, such as repeated stiffening and twisting of muscles, tremors, jitteriness, pacing, and foot tapping. Symptoms might occur as early as within the first 24 to 48 hours of taking prochlorperazine and they typically go away when you stop the medication. Talk with your healthcare provider right away if you experience these symptoms, you might need to lower your dose of prochlorperazine or switch to a different medication. Children should only use prochlorperazine if they are being watched by adults who can recognize these side effects.
Risk factors: Taking antipsychotic medications | Higher than recommended doses of prochlorperazine | Taking lithium (Lithobid)
Prochlorperazine can cause neuroleptic malignant syndrome (NMS), which is a rare but serious condition that can lead to death. Symptoms include a very high fever, stiff muscles, problems thinking clearly, very fast or uneven heartbeat, and sweating. People who take this medication and lithium (Lithobid) might be at higher risk for this side effect. Stop taking prochlorperazine and get medical attention right away if you experience these symptoms. Be careful using prochlorperazine if you're also on other medications that might cause NMS, such as antipsychotics.
Prochlorperazine can cover up more serious health problems. It eases nausea and vomiting, which covers up conditions such as drug overdose or poisoning. It might cause side effects such as sleepiness, confusion, and difficulty controlling muscle movements, which can be confused with conditions such as brain damage, brain tumor, or Reye's syndrome (a rare but serious condition seen in children and teens recovering from viral infections). Children and teenagers who might have Reye’s syndrome should not use this medication.
Risk factors: History of low white blood cell (WBC) counts | Older adults | Taking other medications that lower WBC counts
Prochlorperazine can cause low WBC counts, which might lead to serious infection and in some cases, death. You might need to get lab work done regularly to make sure your white blood cell count is healthy. Talk to your healthcare provider right away if you experience symptoms of an infection, such as fever, weakness, or sore throat, while you're taking this medication.
Risk factors: History of low blood pressure | Taking medications that lower blood pressure
Prochlorperazine can cause low blood pressure, which might lead to fainting and falling. If you need to stand up or sit up, do so slowly. Talk to your healthcare provider if you continue to experience dizziness while taking prochlorperazine.
Prochlorperazine might cause serious liver problems. Talk to your healthcare provider right away if you experience symptoms such as fever, chills, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine.
Risk factors: History of seizures
Taking prochlorperazine puts you at higher risk for seizures. Talk to your healthcare provider if you have a history of seizures, your dose of seizure medications might need to be adjusted. Be careful driving, swimming, or participating in other potentially dangerous activities in which sudden loss of consciousness could cause serious harm.
Prochlorperazine can cause prolactin hormone levels in your blood to go up. High prolactin levels can lead to symptoms such as milky substances being released from the nipple, enlarged breasts, and absent or irregular menstrual periods. Talk to your healthcare provider if you experience or have any concerns about these symptoms.
Risk factors: Extreme heat
Prochlorperazine might make it hard for your body to maintain a normal body temperature. Be careful if you are traveling to a place that is very hot.
Your provider will work with you to prescribe the right dose of prochlorperazine for your individual needs.
Your dose might be lower if you are an older adult or if your body weight is too low.
Severe nausea and vomiting:
Adults: The typical dose is 5 mg to 10 mg by mouth 3 to 4 times daily. The maximum dose is 40 mg a day. Daily doses higher than 40 mg are only used in very severe cases.
Children (age 2 years and older weight 20 lbs or more): Your child's provider will determine the dose based on your child’s body weight. The typical dose is 2.5 mg by mouth ranging from 1 to 3 times daily. The maximum daily dose ranges from 7.5 mg to 15 mg, depending on body weight.
Schizophrenia:
Adults: The typical starting dose is 5 mg to 10 mg by mouth 3 to 4 times daily. Your provider might gradually raise your dose until symptoms are controlled.
Children (ages 2 to 12 years old): The typical starting dose is 2.5 mg by mouth 2 to 3 times daily. Your child's provider might gradually raise the dose until symptoms are controlled. The maximum dose is 20 mg to 25 mg a day.
Generalized anxiety disorder (GAD):
Adults: The typical dose is 5 mg by mouth 3 to 4 times daily. The maximum dose is 20 mg a day. Don't take for longer than 3 months.
For severe nausea and vomiting and schizophrenia, this medication is also available as an injection that's administered by a healthcare provider.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Coma
Drinking large amounts alcohol
Taking high doses of medications that can cause extreme sleepiness, such as opioids and seizure medications
Surgery (for children)
Children under 2 years old or under 20 pounds
Severe nausea and vomiting
Schizophrenia
Generalized anxiety disorder (GAD)
Delayed stomach-emptying caused by diabetes (diabetic gastroparesis)
Severe acid reflux (gastroesophageal reflux disease or GERD) when other medications haven’t worked
Prevention of nausea and vomiting due to cancer medications (chemotherapy) or radiation therapy
Prevention of nausea and vomiting after surgery
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