💊 Prochlorperazine

Antiemetic & Antipsychotic (Phenothiazine)

Generic Name	Prochlorperazine
Drug Class	Phenothiazine Derivative (Dopamine D₂ Receptor Antagonist)
Indications	Severe nausea and vomiting Migraine-associated nausea Vertigo-related vomiting Short-term treatment of anxiety (specialist use)
Mechanism of Action	Blocks dopamine (D₂) receptors in the chemoreceptor trigger zone of the brain, suppressing nausea and vomiting. Also has mild anticholinergic and antihistaminic effects.
Available Forms & Strengths	• Tablet: 5 mg, 10 mg • Buccal tablet: 3 mg • Injection: 12.5 mg/mL
Dosage	Adults: 5–10 mg 2–3 times daily Children: 0.1–0.15 mg/kg per dose (specialist advice)
Route	Oral, Buccal, IM, IV
Common Side Effects	Drowsiness Dizziness Dry mouth Postural hypotension
Serious Adverse Effects	Extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, QT prolongation
Contraindications	• Parkinson’s disease • CNS depression • Bone marrow suppression • Pheochromocytoma
Precautions	• Children and elderly (↑ EPS risk) • Epilepsy • Cardiovascular disease
Drug Interactions	• CNS depressants • Antipsychotics (↑ EPS risk) • QT-prolonging drugs
Pregnancy & Lactation	Pregnancy: Use only if benefit outweighs risk Lactation: Avoid or use with caution
Storage	Store below 30°C, protect from light
References	BNF \| BNF for Children \| Nelson Textbook of Pediatrics

⚠️ Clinical note: Monitor for extrapyramidal symptoms, especially in children and elderly patients. Use lowest effective dose.