Home Drug Guide Prochlorperazine Edisylate

Drug Guide

Generic Name

Prochlorperazine Edisylate

Brand Names Compazine

Classification

Therapeutic: Antiemetic, antipsychotic

Pharmacological: Phenothiazine derivative

FDA Approved Indications

Nausea and vomiting
Preoperative and postoperative nausea
Psychotic disorders
Severe anxiety

Mechanism of Action

Prochlorperazine blocks dopamine receptors in the brain's chemoreceptor trigger zone (CTZ), which reduces nausea and vomiting. It also has antipsychotic effects due to dopamine antagonism in the CNS.

Dosage and Administration

Adult: 5-10 mg orally 3-4 times daily as needed; max dose 40 mg/day

Pediatric: Dosing varies by age and weight; typically 0.15-0.33 mg/kg/day divided into 3-4 doses

Geriatric: Start low, monitor closely; typically 5 mg 3-4 times daily, titrate cautiously

Renal Impairment: Use with caution; consider dose adjustment based on severity

Hepatic Impairment: Use with caution; reduce dose as hepatic metabolism may be impaired

Pharmacokinetics

Absorption: Well absorbed from GI tract

Distribution: Widely distributed, crosses blood-brain barrier

Metabolism: Primarily hepatic via CYP enzymes

Excretion: Renal and hepatic routes

Half Life: About 10-12 hours

Contraindications

Hypersensitivity to phenothiazines
Coma
Bone marrow suppression

Precautions

History of seizures
Children under 2 years old (risk of respiratory depression)
Parkinson's disease
Prostate hypertrophy
Pregnancy Category C; use only if clearly needed

Adverse Reactions - Common

Drowsiness (Common)
Dizziness (Common)
Dry mouth (Common)
Blurred vision (Common)
Constipation (Common)

Adverse Reactions - Serious

Extrapyramidal symptoms (Uncommon)
Neuroleptic malignant syndrome (Rare)
QT prolongation and arrhythmias (Rare)
Blood dyscrasias (Rare)

Drug-Drug Interactions

CNS depressants (increase sedation)
Other QT-prolonging drugs
Lithium (risk of neurotoxicity)
Anticholinergic drugs (antagonistic effects)

Drug-Food Interactions

Alcohol (enhanced sedation)
CNS depressants (additive effects)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for extrapyramidal symptoms, sedation, blood counts, EKG changes

Diagnoses:

Risk for falls due to sedation/dizziness
Risk for impaired mobility
Impaired skin integrity from anticholinergic side effects

Implementation: Administer with food to reduce GI upset, monitor for adverse effects, avoid alcohol and CNS depressants

Evaluation: Assess nausea relief, monitor side effects, EKG if indicated

Patient/Family Teaching

Take medication exactly as prescribed; do not exceed recommended dose
May cause drowsiness; avoid driving or operating machinery
Avoid alcohol and other CNS depressants
Notify provider if signs of abnormal movements, fever, or irregular heartbeat occur
Use sunscreen; photosensitivity may occur

Special Considerations

Black Box Warnings:

Potential for increased mortality in elderly patients with dementia-related psychosis

Genetic Factors: Consider CYP2D6 polymorphisms affecting metabolism

Lab Test Interference: May affect blood cell counts and ECG readings

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, sedation, hypotension, seizures, coma

Treatment: Supportive care, activated charcoal if within appropriate timeframe, anti-Parkinsonian drugs for EPS, cardiopulmonary support

Storage and Handling

Storage: Store at room temperature, away from moisture and light

Stability: Stable for recommended shelf life when stored properly