Prochlorperazine Mesilate

Indications

Prochlorperazine Mesilate is used for: Vertigo, Psychoses, Nausea and vomiting, Severe anxiety disorders

Adult Dose

IV/IM: Nausea and vomiting Adult: As mesilate: 12.5 mg by deep IM. If required, may give further doses via oral admin. Psychoses Adult: As mesilate: 12.5-25 mg by deep IM Inj bid/tid. Oral Prophylaxis of nausea and vomitting Adult: As mesilate: 5-10 mg bid/tid. May also be given rectally. Nausea and vomiting Adult: As mesilate: 20 mg, further doses are given if needed. Recommended buccal dose: As maleate: 3-6 mg bid. Psychoses Adult: As mesilate: 12.5 mg bid for 7 days, adjusted gradually to 75-100 mg daily according to response. Usual maintenance dose: 25-50 mg daily. Adjunct in severe anxiety disorders Adult: As mesilate: 5-10 mg, up to 3-4 times daily. Vertigo Adult: As mesilate: 15-30 mg daily, given in divided doses. May reduce gradually to 5-10 mg daily. Recommended buccal dose: 3-6 mg bid.

Child Dose

Psychoses Child: 1-5 yr: 1.25-2.5 mg; 5-12 yr: 2.5-5 mg. May be given up to tid, if necessary.

Renal Dose

Administration

May be taken with or without food.

Contra Indications

CNS depression, comatose patients. Bone marrow depression, phaechromocytoma, prolactin-dependent tumours, hypersensitivity. Childn <2 yr. Pregnancy and lactation.

Precautions

Extrapyramidal syndrome, hypotension, epilepsy, impaired hepatic, renal, CV, cerebrovascular or respiratory function, glaucoma. May impair ability to drive or perform tasks requiring mental alertness or physical coordination. Parenteral use in children is not recommended. History of jaundice, parkinsonism, diabetes mellitus, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia or urinary retention. Regular eye examinations are recommended in patients on long-term treatment. Lactation: Phenothiazines may be excreted in breast milk; do not nurse

Pregnancy-Lactation

Pregnancy category: C Lactation: Phenothiazines may be excreted in breast milk; do not nurse

Interactions

Additive anticholinergic effects with antihistamines, tricyclic antidepressants and drugs used in parkinsonism. May reduce the antihypertensive effect of guanethidine and other adrenergic neurone blockers. May also increase risk of arrhythmias when used with drugs that prolong QT interval. Potentially Fatal: Potentiation of other CNS depressants including alcohol, sedatives, hypnotics, barbiturates, opioids, antihistamines and general anaesthetics.

Adverse Effects

Side effects of Prochlorperazine Mesilate : <1% Insomnia, Restlessness, Dizziness, Anxiety, Euphoria, Agitation, Depression, Weakness, Headache, Cerebral edema, Poikilothermia, Tachycardia, ECG changes, Anorexia, Dyspepsia, Constipation, Diarrhea, Ileus, Blood dyscrasia, Galactorrhea, Gynecomastia, Ejaculatory disorder, Lens opacities (with prolonged use), Photosensitivity, Pruritus Frequency Not Defined Akathisia, Sedation, Anticholinergic effects, Weight gain, Oligomenorrhea or amenorrhea, Erectile dysfunction, Extrapyramidal symptoms (muscle stiffness, dystonia, parkinsonism, tardive dyskinesia), Neuroleptic malignant syndrome (infrequent but serious), Seizure, Decreased gag reflex, Confusion, Hypotension, Hypertension, Leukopenia, Agranulocytosis, Cholestatic jaundice, Photosensitivity reaction, Priapism, Hepatotoxicity Potentially Fatal: Bone-marrow suppression. Cardiac arrhythmias or aspiration. Potentially Fatal: Bone-marrow suppression. Cardiac arrhythmias or aspiration.

Mechanism of Action

Antiemetic: Antidopaminergic effect, blocking dopamine receptors in the brain, blocking vagus nerve in GI tract. Antipsychotic: Blocking mesolimbic dopamine receptors, and blocking alpha-adrenergic receptors (D1 and D2) in brain.