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Prochlorperazine (Stemetil) 💊
📖 About
Always check the BNF link here for the most up-to-date prescribing information. Prochlorperazine is a potent phenothiazine neuroleptic with antiemetic, antipsychotic, and vestibular suppressant properties.
⚙️ Mode of Action
- 🎯 Dopamine (D₂) receptor antagonist in the chemoreceptor trigger zone (CTZ) → antiemetic effect.
- 🧠 Blocks central dopamine receptors in limbic system and basal ganglia → antipsychotic effect.
- Also has weak anticholinergic and antihistaminic activity → contributes to sedation and side effects.
💊 Indications / Dose
- Severe nausea / vertigo 🤢: 20 mg PO or 12.5 mg IV/IM stat; for ongoing symptoms 5 mg PO TDS.
- Acute migraine 🌩️: 10 mg PO as a single dose, taken at onset of migraine symptoms.
- Schizophrenia / Mania 🧠: 12.5 mg BD for 7 days, then titrated at 4–7 day intervals; usual dose 75–100 mg daily. Deep IM injection: 12.5–25 mg 2–3 times daily.
🔗 Interactions
- 📖 See BNF for full list.
- ⚠️ CNS depression ↑ with alcohol, sedatives, opioids.
- 💓 Additive QT prolongation with other QT-prolonging drugs (e.g., macrolides, antipsychotics, antiarrhythmics).
⚠️ Cautions
- 📊 Monitor biochemical status & ECG if prolonged/high-dose use.
- 👴 Elderly: ↑ risk of sedation, falls, and anticholinergic burden.
- 🧠 Use cautiously in Parkinson’s disease (worsens extrapyramidal symptoms).
⛔ Contraindications
- ❌ Phaeochromocytoma.
- ❌ Known QT prolongation or risk factors for torsades de pointes.
- ❌ Severe CNS depression or coma.
😬 Side Effects
- ⬇️ Orthostatic hypotension, transient drowsiness.
- 💤 Sedation, fatigue.
- 🤖 Extrapyramidal side effects (acute dystonia, akathisia, parkinsonism, tardive dyskinesia).
- 💧 Dry mouth, urinary retention, blurred vision, constipation (anticholinergic effects).
- 👁️ Can worsen glaucoma.
📚 References
- Prochlorperazine – BNF
- NICE Migraine and Antiemetic guidance.
📝 Revisions
- Updated September 2025
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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