Prochlorperazine Maleate is indicated for:

• Control of severe nausea and vomiting associated with radiotherapy, chemotherapy, surgery, and other conditions.
• Relief of nausea, vomiting, dizziness, and vertigo associated with Meniere’s disease and other inner ear disorders.
• Management of psychotic disorders such as schizophrenia (hallucinations and hostility).
• Treatment of acute mania.
• Short-term management of generalized non-psychotic anxiety.

Prochlorperazine is a dopamine and histamine receptor antagonist. Its antiemetic effect is mainly due to blockade of dopamine D2 and histamine H1 receptors in the chemoreceptor trigger zone and vomiting center of the brain. It also exhibits weak anticholinergic activity and helps reduce acid reflux by increasing the tone of the lower esophageal sphincter.

Antiemetic
Children (not recommended in children <10 kg or <2 years):

• 10–14 kg: 2.5 mg every 12–24 hours as needed; maximum: 7.5 mg/day
• 15–18 kg: 2.5 mg every 8–12 hours as needed; maximum: 10 mg/day
• 19–39 kg: 2.5 mg every 8 hours or 5 mg every 12 hours as needed; maximum: 15 mg/day.

Adults: 5–10 mg 3–4 times/day; usual maximum: 40 mg/day

Antipsychotic
Children (not recommended in children <10 kg or <2 years):

• 2–12 years: 2.5 mg 2–3 times/day
• Increase dosage as needed to a maximum daily dose of 20 mg for 2–5 years and 25 mg for 6–12 years

Adults: 5–10 mg 3–4 times/day; doses up to 150 mg/day may be required in some patients for treatment of severe disturbances

Nonpsychotic anxiety

• Adults: Usual dose: 15–20 mg/day in divided doses; do not give doses >20 mg/day or for longer than 12 weeks
• Elderly: Initial: 2.5–5 mg 1–2 times/day; increase dose at 4 to 7 day intervals by 2.5–5 mg/day; increase dosing intervals (twice daily, thrice daily, etc) as necessary to control response or side effects; maximum daily dose should probably not exceed 75 mg in elderly; gradual increases (titration) may prevent some side effects or decrease their severity.

Prochlorperazine may be administered without regard to the meal

Alcohol, barbiturates, and other CNS depressants may enhance the central nervous system depressant effects of prochlorperazine. Antacids, antiparkinsonian drugs, and lithium may reduce or interfere with its absorption. Prochlorperazine may also affect the plasma levels of propranolol and phenobarbital.

Contraindicated in patients with hypersensitivity to prochlorperazine or any ingredient of the formulation, severe CNS depression, or coma. It should not be used in children under 2 years of age or weighing less than 10 kg.

Common side effects include drowsiness; muscle spasms of the jaw, neck, and back; tongue movements resembling worms; involuntary rhythmic movements of the face, mouth, or jaw; slow or difficult speech; difficulty swallowing; restlessness; tremors; shuffling gait; skin rash; and jaundice (yellowing of skin or eyes).

No clear evidence of harmful effects has been reported during pregnancy or breastfeeding.

Caution is required when performing tasks requiring alertness such as driving or operating machinery. Alcohol should be avoided as it may cause severe drowsiness. This medicine may increase sensitivity to sunlight; prolonged sun exposure should be avoided, and protective clothing or sunscreen should be used. It may reduce sweating and increase the risk of heatstroke.

Symptoms of overdose may include deep sleep, coma, extrapyramidal reactions, involuntary muscle movements, and low blood pressure.

Antivertigo drugs, Antiemetic drugs

Store below 30°C in a dry place, protected from light and moisture. Keep out of the reach of children.