Drug reference

Prochlorperazine

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 429, 430

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Schizophrenia and other psychoses | Mania ▶BY MOUTH ▶Adult: 12.5 mg twice daily for 7 days, dose to be adjusted at intervals of 4–7 days according to response; usual dose 75–100 mg daily ▶BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 12.5–25 mg 2–3 times a day Short-term adjunctive management of severe anxiety ▶BY MOUTH ▶Adult: 15–20 mg daily in divided doses; maximum 40 mg per day Nausea and vomiting, acute attack ▶BY MOUTH ▶Adult: Initially 20 mg, then 10 mg after 2 hours ▶BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 12.5 mg as required, to be followed if necessary after 6 hours by an oral dose Nausea and vomiting, prevention ▶BY MOUTH ▶Adult: 5–10 mg 2–3 times a day ▶BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 12.5 mg as required, to be followed if necessary after 6 hours by an oral dose Prevention and treatment of nausea and vomiting ▶BY MOUTH ▶Child 1–11 years (body-weight 10 kg and above): 250 micrograms/kg 2–3 times a day ▶Child 12–17 years: 5–10 mg up to 3 times a day if required ▶BY INTRAMUSCULAR INJECTION ▶Child 2–4 years: 1.25–2.5 mg up to 3 times a day if required ▶Child 5–11 years: 5–6.25 mg up to 3 times a day if required ▶Child 12–17 years: 12.5 mg up to 3 times a day if required Labyrinthine disorders ▶BY MOUTH ▶Adult: 5 mg 3 times a day, increased if necessary to 30 mg daily in divided doses, dose to be increased gradually, then reduced to 5–10 mg daily, dose is reduced after several weeks Nausea and vomiting in previously diagnosed migraine ▶BY MOUTH USING BUCCAL TABLET ▶Child 12–17 years: 3–6 mg twice daily, tablets to be placed high between upper lip and gum and left to dissolve ▶Adult: 3–6 mg twice daily, tablets to be placed high between upper lip and gum and left to dissolve Nervous system Acute migraine ▶BY MOUTH ▶Adult: 10 mg for 1 dose, to be taken as soon as migraine symptoms develop DOSE EQUIVALENCE AND CONVERSION ▶Doses are expressed as prochlorperazine maleate or mesilate; 1 mg prochlorperazine maleate : 1 mg prochlorperazine mesilate. l UNLICENSED USE g Prochlorperazine is used for the treatment of acute migraine, h but is not licensed for this indication. Injection not licensed for use in children. Buccastem M ® tablets not licensed for use in children.

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Contra Indications

Avoid oral route in child under 10 kg . CNS depression. comatose states. phaeochromocytoma

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Cautions

GENERAL CAUTIONS Elderly. hypotension (more likely after intramuscular injection) SPECIFIC CAUTIONS ▶With systemic use Hypothyroidism (in adults) CAUTIONS, FURTHER INFORMATION ▶Elderly Prescription potentially inappropriate (STOPP criteria) in patients with parkinsonism (risk of exacerbating parkinsonian symptoms). See also Prescribing in the elderly p. 33.

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Safety

Interactions

→Appendix 1: phenothiazines

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Side Effects

GENERAL SIDE-EFFECTS ▶Rare or very rare Glucose tolerance impaired. hyperglycaemia. hyponatraemia. SIADH ▶Frequency not known Photosensitivity reaction SPECIFIC SIDE-EFFECTS ▶Rare or very rare ▶With buccal use Blood disorder. hepatic disorders ▶Frequency not known ▶With buccal use Oral disorders. skin eruption ▶With intramuscular use Atrioventricular block. cardiac arrest . eye disorders. jaundice. muscle rigidity. nasal congestion . respiratory depression. skin reactions ▶With oral use Atrioventricular block. autonomic dysfunction. cardiac arrest. consciousness impaired. hyperthermia. jaundice. muscle rigidity. nasal congestion . oculogyric crisis. respiratory depression. skin reactions SIDE-EFFECTS, FURTHER INFORMATION Acute dytonias are more common with potent ﬁrst-generation antipsychotics. The risk is increased in men, young adults, children, antipsychotic-naïve patients, rapid dose escalation, and abrupt treatment discontinuation.

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Hepatic Impairment

Manufacturer advises avoid.

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Renal Impairment

Dose adjustments Start with small doses in severe renal impairment because of increased cerebral sensitivity.

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Dose and formulations

Directions For Administration

▶With buccal use Buccal tablets are placed high between upper lip and gum and left to dissolve.

PDF page 429

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Prochlorperazine (Non-proprietary) Prochlorperazine maleate 5 mg Prochlorperazine 5mg tablets | 28 tablet P £1.98 DT = £1.11 | 84 tablet P £1.96–£3.33 Nervous system ▶Stemetil (Sanofi) Prochlorperazine maleate 5 mg Stemetil 5mg tablets | 28 tablet P £1.98 DT = £1.11 | 84 tablet P £5.94 Solution for injection ▶Stemetil (Sanofi) Prochlorperazine mesilate 12.5 mg per 1 ml Stemetil 12.5mg/1ml solution for injection ampoules | 10 ampoule P £5.23 DT = £5.23 Buccal tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Prochlorperazine (Non-proprietary) Prochlorperazine maleate 3 mg Prochlorperazine 3mg buccal tablets | 50 tablet P £50.27 DT = £27.61 Oral solution CAUTIONARY AND ADVISORY LABELS 2 ▶Stemetil (Sanofi) Prochlorperazine mesilate 1 mg per 1 ml Stemetil 5mg/5ml syrup | 100 ml P £3.34 DT = £3.34 eiiii F 401

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Clinical care

Patient And Carer Advice

▶With buccal use Patients or carers should be given advice on how to administer prochlorperazine buccal tablets.

PDF page 429

Dose text by age group

Adult

12.5 mg twice daily for 7 days, dose to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5–25 mg 2–3 times a day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

15–20 mg daily in divided doses; maximum

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

Initially 20 mg, then 10 mg after 2 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5 mg as required, to be followed if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

5–10 mg 2–3 times a day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5 mg as required, to be followed if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

5–10 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 2–4 years

1.25–2.5 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 5–11 years

5–6.25 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

12.5 mg up to 3 times a day if required

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

5 mg 3 times a day, increased if necessary to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

3–6 mg twice daily, tablets to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

3–6 mg twice daily, tablets to be placed high

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

10 mg for 1 dose, to be taken as soon as migraine

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Prochlorperazine

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 429, 430

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 429

Contra Indications

Avoid oral route in child under 10 kg . CNS depression. comatose states. phaeochromocytoma

PDF page 429

Cautions

PDF page 429

Safety

Interactions

→Appendix 1: phenothiazines

PDF page 429

Side Effects

PDF page 429

Hepatic Impairment

Manufacturer advises avoid.

PDF page 429

Renal Impairment

Dose adjustments Start with small doses in severe renal impairment because of increased cerebral sensitivity.

PDF page 429

Dose and formulations

Directions For Administration

▶With buccal use Buccal tablets are placed high between upper lip and gum and left to dissolve.

PDF page 429

Medicinal Forms

PDF page 430

Clinical care

Patient And Carer Advice

▶With buccal use Patients or carers should be given advice on how to administer prochlorperazine buccal tablets.

PDF page 429

Dose text by age group

Adult

12.5 mg twice daily for 7 days, dose to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5–25 mg 2–3 times a day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

15–20 mg daily in divided doses; maximum

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

Initially 20 mg, then 10 mg after 2 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5 mg as required, to be followed if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

5–10 mg 2–3 times a day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

12.5 mg as required, to be followed if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

5–10 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 2–4 years

1.25–2.5 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 5–11 years

5–6.25 mg up to 3 times a day if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

12.5 mg up to 3 times a day if required

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

5 mg 3 times a day, increased if necessary to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Child 12–17 years

3–6 mg twice daily, tablets to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

3–6 mg twice daily, tablets to be placed high

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Adult

10 mg for 1 dose, to be taken as soon as migraine

First-line fragment. Read the complete Indications and Dose section above.

PDF page 429

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.