Prochlorperazine Maleate
Name: Prochlorperazine Maleate
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Interactions for Prochlorperazine Maleate
Specific Drugs and Laboratory Tests
| Drug or Test | Interaction | Comments |
|---|---|---|
| Anticholinergic drugs (e.g., atropine) | Possible potentiation of anticholinergic effectsb | Use with cautionb |
| Anticoagulants, oral | Potential decreased effect of oral anticoagulants100 f g | |
| Anticonvulsants (e.g., phenytoin) | Prochlorperazine may lower seizure threshold100 f g Prochlorperazine may interfere with phenytoin metabolism and precipitate phenytoin toxicity100 f g | Dosage adjustments of anticonvulsants may be necessary100 f g |
| CNS depressants (e.g., alcohol, anesthetics, opiates) | May potentiate CNS depression100 f g | Use with caution to avoid excessive sedation or CNS depressionb |
| Epinephrine or dopamine | Concomitant use may cause further lowering of BP100 b f g | Do not use epinephrine or dopamine to treat phenothiazine-induced hypotension100 b f g (see Hypotension under Cautions) |
| Guanethidine and related compounds | Potential for decreased effectiveness of guanethidine and related compounds100 f g | |
| Lithium | Possible acute encephalopathic syndrome, especially with high serum lithium concentrationsb | Observe patients receiving combined therapy for evidence of adverse neurologic effects; discontinue treatment promptly if such signs or symptoms appearb |
| Propranolol | Increased plasma concentrations of prochlorperazine and propranolol100 f g | |
| Test for phenylketonuria (PKU) | Potential false positive test results100 f g | |
| Thiazide diuretics | Potential for increased orthostatic hypotension100 f g |
Prochlorperazine Maleate Pharmacokinetics
Absorption
Bioavailability
Phenothiazines are generally well absorbed from the GI tract and from parenteral sites.b
Onset
Psychotic disorders: Symptomatic relief may be seen during the first 2 days of oral therapy; however, optimum antipsychotic effect usually requires prolonged administration.d
Antiemetic effects: Onset in 30–40 minutes (conventional tablet), 60 minutes (rectal suppository), or 10–20 minutes (IM administration).a
Duration
Antiemetic effects: Duration of 3–4 hours (conventional tablet, rectal suppository, or IM administration).a
Distribution
Extent
Phenothiazines are distributed into most body tissues and fluids, with high concentrations being distributed into the brain, lungs, liver, kidneys, and spleen.b
Phenothiazines cross the placenta.b m Prochlorperazine is distributed into milk.100 f g
Plasma Protein Binding
Phenothiazines are highly bound to plasma proteins.b
Elimination
Metabolism
Extensively metabolized, principally in the liver.b
Elimination Route
Phenothiazines and their metabolites are excreted in urine and feces.b
Stability
Storage
Rectal
Suppositories20–25°C.g Do not remove from wrapper until ready to use.g
Oral
Tablets20–25°C.100 Protect from light.100
Parenteral
Injection20–25°C; do not freeze.f Protect from light.f
Compatibility
For information on systemic interactions resulting from concomitant use, see Interactions.
Parenteral
Solution CompatibilityHID| Compatible |
|---|
| Dextran 6% in dextrose 5% |
| Dextran 6% in sodium chloride 0.9% |
| Dextrose–Ringer’s injection combinations |
| Dextrose–Ringer’s injection, lactated, combinations |
| Dextrose–saline combinations |
| Dextrose 2½, 5, or 10% in water |
| Ionosol products |
| Ringer’s injection |
| Ringer’s injection, lactated |
| Sodium chloride 0.45 or 0.9% |
| Sodium lactate (1/6) M |
| Compatible |
|---|
| Amikacin sulfate |
| Ascorbic acid injection |
| Calcium gluconate |
| Dexamethasone sodium phosphate |
| Dimenhydrinate |
| Erythromycin lactobionate |
| Ethacrynate sodium |
| Lidocaine HCl |
| Nafcillin sodium |
| Penicillin G potassium |
| Sodium bicarbonate |
| Incompatible |
| Aminophylline |
| Chloramphenicol sodium succinate |
| Floxacillin sodium |
| Furosemide |
| Thiopental sodium |
| Compatible |
|---|
| Amsacrine |
| Calcium gluconate |
| Cisatracurium besylate |
| Cisplatin |
| Cladribine |
| Cyclophosphamide |
| Cytarabine |
| Dexmedetomidine HCl |
| Docetaxel |
| Doxorubicin HCl |
| Doxorubicin HCl liposome injection |
| Fluconazole |
| Granisetron HCl |
| Heparin sodium |
| Hetastarch in lactated electrolyte injection (Hextend) |
| Hydrocortisone sodium succinate |
| Linezolid |
| Melphalan HCl |
| Methotrexate sodium |
| Ondansetron HCl |
| Oxaliplatin |
| Paclitaxel |
| Potassium chloride |
| Propofol |
| Remifentanil HCl |
| Sargramostim |
| Sufentanil citrate |
| Teniposide |
| Thiotepa |
| Topotecan HCl |
| Vinorelbine tartrate |
| Incompatible |
| Aldesleukin |
| Allopurinol sodium |
| Amifostine |
| Amphotericin B cholesteryl sulfate complex |
| Aztreonam |
| Bivalirudin |
| Cefepime HCl |
| Etoposide phosphate |
| Fenoldopam mesylate |
| Filgrastim |
| Fludarabine phosphate |
| Foscarnet sodium |
| Gallium nitrate |
| Gemcitabine HCl |
| Pemetrexed disodium |
| Piperacillin sodium–tazobactam sodium |
Actions
-
Exhibits weak anticholinergic effects, moderate sedative effects, strong extrapyramidal effects, and strong antiemetic effects.a
-
May antagonize dopamine-mediated neurotransmission at the synapses and may block postsynaptic dopamine receptor sites; however, precise mechanism(s) of action have not been determined.b
-
Exerts an antiemetic effect by directly affecting the medullary chemoreceptor trigger zone (CTZ), apparently by blocking dopamine receptors in the CTZ.a g Inhibits apomorphine-induced vomiting.a
-
Also has peripheral and/or central antagonistic activity against α-adrenergic, serotonergic, histaminic H1, and muscarinic receptors.b
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
| Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
| Rectal | Suppositories | 25 mg* | Compro | Paddock |
| Prochlorperazine Suppositories |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
| Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
| Parenteral | Injection | 5 mg (of prochlorperazine) per mL* | Prochlorperazine Edisylate Injection |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
| Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
| Oral | Tablets, film-coated* | 5 mg (of prochlorperazine)* | Prochlorperazine Maleate Tablets | |
| 10 mg (of prochlorperazine)* | Prochlorperazine Maleate Tablets |
Uses
Consult your pharmacist.
How to use Prochlorperazine Maleate Powder
Consult your pharmacist.