Prochlorperazine

About Prochlorperazine

Prochlorperazine is classified as both an antiemetic and an antipsychotic. The tablets are labeled for severe nausea and vomiting, for schizophrenia, and for short-term treatment of generalized non-psychotic anxiety; for anxiety it is not the first drug to use for most patients and is limited to 20 mg a day for no more than 12 weeks, because higher doses or longer use may cause lasting movement problems. For nausea, adults usually take 5 or 10 mg three or four times a day, and more than 40 mg a day is kept for resistant cases. The suppository is 25 mg twice a day and is labeled only for adults. Prochlorperazine is not used in children under 2 years old or under 20 pounds; above that, a child’s tablet dose for nausea is set by weight, and more than one day of treatment is seldom needed.

The boxed warning says older adults with dementia-related psychosis who take antipsychotics have a higher risk of death, and prochlorperazine is not approved for them. Tardive dyskinesia, involuntary movements that may not go away, becomes more likely with longer use and higher total doses, and neuroleptic malignant syndrome (high fever, rigid muscles, confusion) needs emergency care. Spasm of the neck muscles, throat tightness, trouble swallowing or breathing, or a protruding tongue can start in the first few days, and restlessness or Parkinson-like stiffness and tremor can also occur; children who are dehydrated or acutely ill, for example with chickenpox, measles or gastroenteritis, are much more prone to these reactions. Drowsiness, dizziness, blurred vision and low blood pressure can occur, and drowsiness, a drop in blood pressure on standing and unsteadiness can lead to falls. It is not used in coma, with large amounts of alcohol or other sedatives, with a known allergy to phenothiazines, or for children having surgery.

It can lower white blood cell counts, so a sore throat or other sign of infection should be reported, and it needs caution in glaucoma and in extreme heat, since it can interfere with the body’s temperature control. Because it stops vomiting, it may hide the signs of other problems, such as a bowel obstruction, and it is avoided in children and teenagers whose illness suggests Reye’s syndrome. Newborns exposed in the last three months of pregnancy are at risk of movement and withdrawal symptoms. The original brand, Compazine, is no longer sold; the Compro carton says it is not for use in children, and the injection is given by a health professional.

Taking Prochlorperazine

How to take it

Take the tablets exactly as prescribed, usually three or four times a day for adults, and do not take more or take them more often than directed. For a suppository, wash your hands, unwrap it (chill it briefly first if it is soft), lie on your side and insert it pointed end first into the rectum, then stay lying down for about 15 minutes.

If you miss a dose

Take it when you remember unless the next dose is nearly due; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature in the original, tightly closed container, away from heat, moisture and light; keep suppositories in their wrappers until use. Keep it out of reach of children, and use a medicine take-back program for leftovers.

Interactions to know about

Alcohol, opioids, sleep medicines and other sedatives add to its drowsiness. It can weaken oral blood thinners, may interfere with phenytoin and bring on phenytoin toxicity, and can lower the seizure threshold; propranolol raises levels of both drugs, thiazide diuretics add to dizziness on standing, and a serious brain reaction has been reported with lithium.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Prochlorperazine differs from pharmacy to pharmacy

Generic tablets come from many manufacturers, and when the fill is small, the dispensing fee can be much of a cash quote. Quotes also depend on whether a pharmacy keeps prochlorperazine on a flat-price generic list.

Suppositories are a different market: far fewer companies make them, they come in boxes of 12, and a pharmacy that does not keep them in stock may need to order them, which can delay the fill.

Ways to pay less for Prochlorperazine without insurance

• Ask whether prochlorperazine tablets are on the pharmacy’s flat-price generic list.
• Compare more than one quote; with a small fill, the dispensing fee can be much of the price.
• If suppositories are prescribed, confirm the pharmacy has them in stock before the prescription is sent, and ask whether the quote is for Compro or the generic.
• For long-term use in schizophrenia, ask for a ninety-day supply once the dose is settled.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Prochlorperazine

1. 1.Which muscle spasms or movements mean I should stop and call my doctor?
2. 2.Is it safe for my child at this age and weight, and while they are sick?
3. 3.Does it interact with my blood thinner, seizure, blood pressure or sleep medicines?
4. 4.How do I insert and store my suppositories?

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