Prochlorperazine

(proe klor per' a zeen)

Brand Name(s): Compazine^®¶, Compro^®, Procomp^®; also available generically

IMPORTANT WARNING:

Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as prochlorperazine have an increased chance of death during treatment.

Prochlorperazine is not approved by the Food and Drug Administration (FDA) for the treatment of behavior problems in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is taking prochlorperazine. For more information, visit the FDA website: http://www.fda.gov/Drugs

WHY is this medicine prescribed?

Prochlorperazine suppositories and tablets are used to control severe nausea and vomiting. Prochlorperazine tablets are also used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Prochlorperazine tablets are also used on a short-term basis to treat anxiety that could not be controlled by other medications. Prochlorperazine should not be used to treat any condition in children who are younger than 2 years old or who weigh less than 20 pounds (about 9 kilograms). Prochlorperazine is in a class of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Prochlorperazine comes as a tablet to take by mouth and as a suppository to place in the rectum. Prochlorperazine tablets are usually taken three to four times a day by adults and are usually given to children one to three times a day. Prochlorperazine suppositories are usually inserted twice a day. Use prochlorperazine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use prochlorperazine exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your doctor may start you on a low dose of prochlorperazine and gradually increase your dose, not more often than once every 2-3 days.

If you are using prochlorperazine to treat schizophrenia, prochlorperazine may help control your symptoms but will not cure your condition. Continue to use prochlorperazine even if you feel well. Do not stop using prochlorperazine without talking to your doctor. If you suddenly stop using prochlorperazine, you may experience withdrawal symptoms such as nausea, vomiting, dizziness, and shakiness.

To insert a prochlorperazine suppository, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. If the suppository is soft, hold it under cool water or place it in the refrigerator for a few minutes to harden it before removing the wrapper.
3. Remove the wrapper, if present.
4. If you were told to use half of the suppository, cut it lengthwise with a clean, sharp blade.
5. Put on a finger cot or disposable glove, if desired (available at a pharmacy).
6. Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water.
7. Lie on your side with your lower leg straightened out and your upper leg bent forward toward your stomach.
8. Lift upper buttock to expose the rectal area.
9. Insert the suppository, pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1/2 to 1 inch (1.25 to 2.5 centimeters) in infants and 1 inch (2.5 centimeters) in adults. If not inserted past this sphincter, the suppository may pop out.
10. Hold buttocks together for a few seconds.
11. Remain lying down for about 15 minutes to avoid having the suppository come out.
12. Try to avoid having a bowel movement for about an hour so that the medication in the suppository can be absorbed into the body.
13. Discard used materials and wash your hands thoroughly.

What SPECIAL PRECAUTIONS should I follow?

Before using prochlorperazine,

• tell your doctor and pharmacist if you are allergic to prochlorperazine, other phenothiazines such as chlorpromazine, fluphenazine, perphenazine, promethazine (Phenergan), thioridazine, and trifluoperazine; or any other medications. If you will be taking prochlorperazine tablets, also tell your doctor if you are allergic to tartrazine (a yellow dye found in some foods and medications) or aspirin.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants; antihistamines; atropine (in Motofen, in Lomotil, in Lonox); barbiturates such as pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal); diuretics ('water pills'); epinephrine (Epipen); guanethidine (not available in the US); ipratropium (Atrovent); lithium (Eskalith, Lithobid), medications for anxiety, irritable bowel disease, mental illness, Parkinson's disease, motion sickness, ulcers, or urinary problems; medications for seizures such as phenytoin (Dilantin); narcotic medications for pain; propranolol (Inderal); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision), trouble keeping your balance, seizures, an abnormal electroencephalogram (EEG; test that measures electrical activity in the brain), brain damage, pheochromocytoma (tumor on a small gland near the kidneys), breast cancer, any condition that affects the production of blood cells by your bone marrow, or heart disease. Also tell your doctor if you have ever had to stop taking a medication for mental illness due to severe side effects and if you plan to work with organophosphorus insecticides (a type of chemical used to kill insects).

• if you will be giving prochlorperazine to a child, tell the child's doctor if the child has chickenpox, measles, a stomach virus, or an infection of the brain or spinal cord. Also tell the child's doctor if the child has any of the following symptoms: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. Be sure to tell the child's doctor if the child has not been drinking normally, has excessive diarrhea, or appears dehydrated.

• if you will be using prochlorperazine to treat nausea and vomiting, it is important to tell your doctor about any other symptoms you are experiencing, especially listlessness; drowsiness; confusion; aggression; seizures; headaches; problems with vision, hearing, speech, or balance; stomach pain or cramps; or constipation. Nausea and vomiting that is experienced along with these symptoms may be a sign of a more serious condition that should not be treated with prochlorperazine.

• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking prochlorperazine, call your doctor. Ptrochlorperazine may cause problems in newborns following delivery if it is taken during the last months of pregnancy.

• you should know that this medication may make you drowsy and may affect your thinking and movements, especially at the beginning of your treatment. Do not drive a car or operate machinery until you know how this medication affects you.

• ask your doctor about the safe use of alcohol during your treatment with prochlorperazine. Alcohol can make the side effects of prochlorperazine worse.

• you should know that prochlorperazine may cause dizziness, especially when you get up from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

• you should know that prochlorperazine may make it harder for your body to cool down when it gets very hot. Tell your doctor if you plan to do vigorous exercise or be exposed to extreme heat.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Prochlorperazine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness, feeling unsteady, or having trouble keeping your balance
• blurred vision
• dry mouth
• stuffed nose
• headache
• nausea
• constipation
• difficulty urinating
• widening or narrowing of the pupils (black circles in the center of the eyes)
• increased appetite
• weight gain
• agitation
• jitteriness
• difficulty falling asleep or staying asleep
• blank facial expression
• drooling
• uncontrollable shaking of a part of the body
• shuffling walk
• breast enlargement
• breast milk production
• missed menstrual periods
• decreased sexual ability in men

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• fever
• muscle stiffness
• falling
• confusion
• fast or irregular heartbeat
• sweating
• yellowing of the skin or eyes
• flu-like symptoms
• sore throat, chills, and other signs of infection
• neck cramps
• tongue that sticks out of the mouth
• tightness in the throat
• difficulty breathing or swallowing
• fine, worm-like tongue movements
• uncontrollable, rhythmic face, mouth, or jaw movements
• seizures
• rash
• hives
• itching
• swelling of the eyes, face, mouth, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
• vision loss, especially at night
• seeing everything with a brown tint
• coma (loss of consciousness for a period of time)
• erection that lasts for hours

Prochlorperazine may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store prochlorperazine suppositories in their wrappers; do not unwrap a suppository until just before you insert it. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• agitation
• jitteriness
• difficulty falling asleep or staying asleep
• blank facial expression
• drooling
• uncontrollable shaking of a part of the body
• shuffling walk
• sleepiness
• coma (loss of consciousness for a period of time)
• seizures
• irregular heartbeat
• fever
• dry mouth
• constipation

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Before having any laboratory test, tell your doctor and the laboratory technician that you are taking prochlorperazine.

Prochlorperazine may interfere with the results of home pregnancy tests. Talk to your doctor if you think you might be pregnant during your treatment with prochlorperazine. Do not try to test for pregnancy at home.

Do not let anyone else take or use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

^¶ This branded product is no longer on the market. Generic alternatives may be available.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: February 15, 2018.