Pronunciation: KOMP-ah-zeen

Generic name(s): prochlorperazine

Drug Class: phenothiazine/antipsychotic

Indications: management of severe nausea and vomiting, psychotic disorders, non-psychotic anxiety

How supplied: 5-mg and 10-mg tablets, 10-mg and 15-mg sustained-release capsules, syrup (5 mg/teaspoon), 2.5-mg, 5-mg, 25-mg rectal suppositories, 2 mL and 10 mL vials (5 mg/mL)

Dosage for adults: tablets: 15-40 mg; sustained-release capsules: 10-15 mg; suppositories: 25 mg, intramuscular: 5-40 mg; intravenous: 2.5-10 mg

Dosage for children: 20-29 lbs (9-13 kg): 2.5-7.5 mg; 30-39 lbs (13-17.5 kg): 5-10 mg; 40-85 lbs (18-38.5 kg): 7.5-15 mg. Not recommended for children under 20 lbs (9 kg).

Contraindications: Compazine should not be given to patients who are taking other central nervous system depressants, such as alcohol, barbiturates, or narcotics. It should not be used in pediatric surgery, nor should it be given to children under 20 lbs. It should not be combined with Amipaque or Dilantin.

Precautions: Compazine can be used to treat severe vomiting, but it is important to remember that chronic vomiting may indicate a serious disorder (brain tumor, intestinal obstruction, etc.) that requires separate treatment. It should be used with caution in patients who have glaucoma, are at high risk of hypotension, or are frequently exposed to extreme heat, as it may exacerbate these conditions. These drugs can also produce alpha-adrenergic blockade. Phenothiazines in general cause elevated prolactin levels, which may be associated with breast cancer; use with caution in patients at risk for this form of cancer. There are no studies that establish the safety of Compazine in pregnant women; therefore, they should avoid Compazine unless they experience vomiting or nausea that is so severe that the benefits of the drug outweigh the potential risks.

Interactions: Compazine may reduce the effects of anticoagulants. When used with thiazide diuretics, it may increase the risk of hypotension. It may diminish the effects of high-blood-pressure drugs like guanethidine.

Common Side-Effects: Drowsiness, dizziness, cessation of menstrual periods, blurred vision, hypotension, neuroleptic malignant syndrome, and tardive dyskinesia.

Warnings: When patients first start taking Compazine, they may experience changes in concentration and alertness, so patients should be careful about operating machinery, engaging in dangerous activity, etc., until they learn how the drug affects them. Long-term use of all phenothiazines, including Compazine, can cause tardive dyskinesia, which is a potentially irreversible syndrome involving constant involuntary movements. This syndrome sometimes--but not always--goes away when the drug is removed. Therefore, Compazine should be used with extreme caution and at the lowest possible dose for periods longer than a few months. Compazine can also cause neuroleptic malignant syndrome, which involves high fever, muscle rigidity, irregular pulse or heartbeat, and possibly death.

Date of most recent update: 1/31/03

This writeup is intended only to provide information, not to recommend the prescription or use of this medication.

Sources: A Primer of Drug Action, Robert Julien
Physicians Desk Reference

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