π 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.
βοΈ Mode of Action
- π― Dopamine (Dβ) receptor antagonist in the chemoreceptor trigger zone (CTZ) β antiemetic effect.
- π§ Blocks central dopamine receptors in limbic system and basal ganglia β antipsychotic effect.
- Also has weak anticholinergic and antihistaminic activity β contributes to sedation and side effects.
π Indications / Dose
- Severe nausea / vertigo π€’: 20 mg PO or 12.5 mg IV/IM stat; for ongoing symptoms 5 mg PO TDS.
- Acute migraine π©οΈ: 10 mg PO as a single dose, taken at onset of migraine symptoms.
- Schizophrenia / Mania π§ : 12.5 mg BD for 7 days, then titrated at 4β7 day intervals; usual dose 75β100 mg daily.
Deep IM injection: 12.5β25 mg 2β3 times daily.
π Interactions
- π See BNF for full list.
- β οΈ CNS depression β with alcohol, sedatives, opioids.
- π Additive QT prolongation with other QT-prolonging drugs (e.g., macrolides, antipsychotics, antiarrhythmics).
β οΈ Cautions
- π Monitor biochemical status & ECG if prolonged/high-dose use.
- π΄ Elderly: β risk of sedation, falls, and anticholinergic burden.
- π§ Use cautiously in Parkinsonβs disease (worsens extrapyramidal symptoms).
β Contraindications
- β Phaeochromocytoma.
- β Known QT prolongation or risk factors for torsades de pointes.
- β Severe CNS depression or coma.
π¬ Side Effects
- β¬οΈ Orthostatic hypotension, transient drowsiness.
- π€ Sedation, fatigue.
- π€ Extrapyramidal side effects (acute dystonia, akathisia, parkinsonism, tardive dyskinesia).
- π§ Dry mouth, urinary retention, blurred vision, constipation (anticholinergic effects).
- ποΈ Can worsen glaucoma.
π References
π Revisions