Chlorpromazine

Chlorpromazine is aprescriptionmedicationused to treat the symptoms ofSchizophrenia, Psychotic Disorders,Nauseaand Vomiting,PreoperativeApprehension,IntraoperativeSedation,IntractableHiccups, andAcuteIntermittentPorphyria

Chlorpromazine is available under the following different brand names: Thorazine

Adult andPediatricdosage

Tablet

• 10mg
• 25mg
• 50mg
• 100mg
• 200mg

Injectable solution

• 25mg/mL

Schizophrenia, Psychotic Disorders

Adult dosage

• Orally: 30-75mgper day divided every 6-12 hours initially; maintenance: usually 200 mg per day (up to 800 mg per dayinsome patients; some patients may require 1-2 g per day)
• IV/IM: 25 mg initially, followed as needed with 25-50 mg after 1-4 hours, then increased to maximum of 400 mg every 4-6 hours until is controlled; usual dosage 300-800 mg per day

Behavioral Disorders,Hyperactivity

Pediatric Dosage

• 小于6个月的年龄:安全性和有效性not established
• 6 months and older: 50-100 mg per day orally or IM; 200 mg per day or more may be necessary for older hospitalized patients; for outpatients, may administer 0.55 mg/kg every 4-6 hours as needed

Nausea and Vomiting

Adult Dosage

• Orally: 10-25 mg every 4-6 hours as needed
• IV/IM: 25-50 mg ever 4-6 hours as needed

Pediatric Dosage

• 小于6个月的年龄:安全性和有效性not established
• 6 months and older: 0.5-1 mg/kg orally or IM every 6-8 hours as needed

Preoperative Apprehension

Adult Dosage

• 25-50 mg orally 2-3 hours beforesurgery
• 12.5-25 mg IM 1-2 hours before surgery

Pediatric Dosage

• 小于6个月的年龄:安全性和有效性not established
• 6 months and older: 0.55 mg/kg orally or IM 1-2 hours before surgery

术中镇静

Adult Dosage

• 12.5 IM every 30 minutes or 2 mg IV every 2 minutes; total dose not to exceed 25 mg

Intractable Hiccups

Adult Dosage

• 25-50 mg orally every 6-8 hours; if hiccups persist after 2-3 days oforaltherapy, administer 25-50 mg IM every 3-4 hours; if symptoms persist, administered 25-50 mg by slow IV infusion with病人lying flat in a bed; monitorblood pressure

Acute Intermittent Porphyria

Adult Dosage

• 25-50 mg orally every 6-8 hours

Dosage Considerations – Should be Given as Follows:

• See "Dosages."

Common side effects of Chlorpromazine include:

• drowsiness,
• dry mouth,
• stuffy nose,
• blurred vision,
• constipation,
• impotence, and
• trouble having anorgasm

Serious side effects of Chlorpromazine include:

• hives,
• difficultybreathing,
• swelling of your face,lips,tongue, orthroat,
• uncontrolledmusclemovements in your face (chewing,lipsmacking, frowning, tongue movement, blinking oreyemovement),
• stiffness in yourneck,
• tightness in your throat,
• trouble swallowing,
• lightheadedness,
• confusion,
• agitation,
• feeling jittery,
• trouble sleeping,
• weakness,
• breastswelling ordischarge,
• seizure,
• yellowing of theskinor eyes (jaundice),
• fever,
• chills,
• mouthsores,
• skin sores,
• sore throat,
• cough,
• very stiff (rigid) muscles,
• high fever,
• sweating,
• confusion,
• fast or uneven heartbeats, and
• tremors

Rare side effects of Chlorpromazine include:

• none

This is not a complete list of side effects and other serious side effects orhealthproblems may occur as a result of the use of this drug. Call yourdoctorfor medical advice about serious side effects or adverse reactions. You may report side effects or health problems toFDAat 1-800-FDA-1088.

If your medical doctor is using this medicine to treat yourpain, your doctor orpharmacist可能已经aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

• Chlorpromazine has severe interactions with the following drugs:
  • disopyramide
  • eliglustat
  • ibutilide
  • indapamide
  • metrizamide
  • pentamidine
  • pimozide
  • procainamide
  • quinidine
  • sotalol
• Chlorpromazine has serious interactions with at least 109 other drugs.
• Chlorpromazine has moderate interactions with at least 318 other drugs.
• Chlorpromazine hasminorinteractions with at least 67 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to phenothiazines
• Coma, severehypotension, severecentral nervous system(CNS)depression, concurrent administration of large amounts of CNS depressants, subcorticalbraindamage, poorly controlled seizure disorder
• Severecardiovascular disease
• Lactation

Effects of drug abuse

• None

Short-Term Effects

• See “What are Side Effects Associated with Using Chlorpromazine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Chlorpromazine?”

Cautions

• Avoid using in children with suspectedReye syndrome
• Use caution inglaucoma, prostatichypertrophy, stenosingpeptic ulcerdisease(PUD), history of NMS,Parkinson disease,hypocalcemia,renalorhepaticimpairment, history of severe reaction toinsulinorelectroconvulsive therapy(ECT), history of seizures,asthma,respiratorytractinfection,cardiovasculardisease, myelosuppression
• Risk of extrapyramidal symptoms (EPS), NMS, hypotension
• Significant hypotension may occur, especially withparenteraladministration; hypotension may be particularly severe in patients with pheochromocytoma ormitral insufficiency; in case of severe hypotension, treat withnorepinephrineor phenylepinephrine, and do not useepinephrineordopamine
• May altercardiacconduction; life threatening arrhythmias reported withtherapeuticdoses of phenothiazines; may cause QT prolongation and subsequent torsade de pointes; avoid use in patients diagnosed or suspectedcongenitallong QT syndrome
• May causeanticholinergiceffects; use caution in patients withparalytic ileus,gastrointestinalmotility,urinary保留,xerostomia, or visual problems
• Agranulocytosis,leukopenia, andneutropeniareported withantipsychoticuse; periodicblood countassessment recommended in patients with history of risk factors, including history of drug-induced leuko/neutropenia or preexisting lowWBC
• Esophagealdysmotility andaspirationreported with antipsychotic use; use caution in patients at risk of肺炎
• May cause extrapyramidal symptoms, includingakathisia, acute dystonic reactions, and pseudoparkinsonism, andtardive dyskinesia; risk ofdystoniagreater with increased doses
• Therapy is associated with increasedprolactinlevels; significance unknown
• May cause pigmentaryretinopathy, and lenticular andcornealdeposits with prolonged therapy
• May causeorthostatic hypotension; use caution in patients with risk factors, including patients who do not tolerate transienthypotensiveepisodes such ashypovolemia,cerebrovascular disease, cardiovascular disease, or medication predisposing to hypotension/bradycardia
• May impair physical or mental abilities due to sedating properties; use caution when operating heavy machinery
• Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- orhyperthermia
• Antiemetic effect may obscuretoxicityof chemotherapeutic drugs
• Anticholinergic antiparkinsonian agent may be needed to counter EPS
• Strong anticholinergic agent andalpha blocker
• Potential forpriapism

USFood and Drug Administration(FDA) warning regardingoff-label usefordementiain elderly (see Black Box Warnings)

Pregnancyand Lactation

• Neonates exposed to antipsychotic drugs during 3rdtrimesterof pregnancy are at risk for EPS orwithdrawal symptomsafter delivery; these complications vary in severity, with some being self-limited and others necessitatingICUsupport and prolonged hospitalization
• Drug entersbreast milk; not recommended.