Prochlorperazine is an antipsychotic medication primarily used to treat and control a variety of symptoms, including severe nausea and vomiting, anxiety, agitation, and schizophrenia. This drug belongs to the phenothiazine class, exerting its therapeutic effects by blocking dopamine receptors and serotonin receptors in the brain.
Clinically, prochlorperazine is often used as an antiemetic, especially effective in cases of severe nausea and vomiting following chemotherapy or surgery. Additionally, it can alleviate unstable emotions and hyperexcitability caused by neurological or psychiatric conditions, but must be used strictly according to medical instructions to avoid serious side effects.
The scientific name of this medication is prochlorperazine. Common brand names in Taiwan and Hong Kong include "Compazine" and "Stemetil." Different formulations (such as tablets, injections, patches) may vary by manufacturer, but the active ingredient remains prochlorperazine.
Prochlorperazine is classified as phenothiazine antipsychotic and antiemetic. Its primary mechanism of action involves antagonizing dopamine D2 receptors, while also possessing antihistamine and anticholinergic effects, allowing it to simultaneously relieve nausea and psychiatric symptoms.
The main indications include:
1. Severe nausea and vomiting post-radiotherapy, chemotherapy, or surgery
2. Acute manic episodes in schizophrenia and bipolar disorder
3. Anxiety or tension before and after surgery
4. Nausea and vertigo caused by migraines.
Physicians may expand the use based on clinical judgment, but this should be based on risk-benefit assessment. Off-label uses should be avoided to reduce unnecessary side effects.
Mild side effects include dry mouth, blurred vision, drowsiness, muscle rigidity, and orthostatic hypotension. These symptoms usually appear early in treatment, and most patients will gradually adapt. If symptoms are severe, medical personnel should be notified immediately.
Serious side effects include: extrapyramidal symptoms (such as involuntary movements), QT interval prolongation, neuroleptic malignant syndrome. Immediate medical attention is required if symptoms like high fever, muscle rigidity, or irregular heartbeat occur.
Contraindications include: glaucoma, history of epilepsy, severe hepatic or renal impairment, allergy to phenothiazines. Pregnant and breastfeeding women should evaluate risks before use, as it may cause muscle rigidity in the fetus or newborn.
This medication can affect judgment and reaction time. During treatment, avoid operating machinery or driving. Long-term use may lead to tardive dyskinesia, which can persist for weeks or years after discontinuation.
Using with monoamine oxidase inhibitors (MAOIs) may trigger hypertensive crises; at least 14 days should pass between discontinuing MAOIs and starting prochlorperazine. When combined with anticoagulants (such as warfarin), it may enhance anticoagulant effects, increasing bleeding risk.
Oral formulations typically start at 5-10 mg per day, divided into multiple doses; in severe nausea and vomiting, doses may be increased to 20-30 mg daily. Injectable forms are used for emergencies and should be administered by healthcare professionals. Patches should be applied to the skin and replaced every 7 days.
It is recommended to take the medication after meals or with food to reduce gastrointestinal discomfort. When using other medications concurrently, inform your doctor of all prescriptions and over-the-counter drugs to avoid interactions.
If a dose is missed, it should be taken as soon as possible; if the next dose is due within 4 hours, skip the missed dose and resume the regular schedule. Do not double doses to make up for missed ones to prevent toxicity.
Overdose may cause coma, respiratory depression, and arrhythmias. If overdose is suspected, seek immediate medical attention and bring the medication container for reference. Symptoms of poisoning include muscle rigidity, dilated pupils, and disorientation.
Emergency measures include gastric lavage, activated charcoal, and ECG monitoring. Long-term overdose can cause permanent neurological damage; therefore, do not adjust doses independently.
Q: If I forget to take prochlorperazine on time, what should I do?
If you miss a dose, take it as soon as possible. However, if it is close to the next scheduled dose, skip the missed dose and continue with your regular schedule. Do not take double doses to compensate for missed ones to avoid increased side effects. It is recommended to set reminders or use a pill organizer to help remember.
Q: Can I safely drive or operate machinery while taking prochlorperazine, given it may cause drowsiness?
This medication may cause dizziness or drowsiness, affecting reaction times. It is advisable to avoid driving or operating dangerous machinery during initial use until you confirm your response to the medication. If side effects persist, consult your doctor for dose adjustment.
Q: Does long-term use of prochlorperazine lead to dependence or addiction?
This medication does not cause drug dependence directly, but long-term use may lead to drug-induced movement disorders and other adverse effects. If discontinuing, gradually reduce the dose under medical supervision to prevent withdrawal symptoms. Patients should not extend their usage period without medical advice.
Q: Can I take other painkillers or cold medicines while on prochlorperazine?
Combining with certain analgesics (such as aspirin, ibuprofen) or cold medicines containing antihistamines may increase drowsiness or affect the nervous system. Always inform your healthcare provider of all medications you are taking, including over-the-counter drugs, to avoid interactions.
Q: Can prochlorperazine affect liver or kidney function? Is regular testing necessary during treatment?
Prolonged or high-dose use may slightly impact liver function, but severe liver damage is rare. If you have liver or kidney issues, your doctor will adjust the dose and require regular blood tests. If symptoms such as jaundice or dark urine occur, stop medication and seek medical attention immediately.
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