Compazine: Effective Relief for Severe Nausea and Psychotic Disorders
Compazine
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Synonyms | |||
Compazine (prochlorperazine) is a phenothiazine antipsychotic and antiemetic agent with established efficacy in clinical practice. It is indicated for the management of severe nausea and vomiting, as well as for the control of manifestations of psychotic disorders. Its mechanism of action involves blocking dopamine receptors in the chemoreceptor trigger zone and the brain, which underlies its dual therapeutic benefits. Healthcare providers value Compazine for its rapid onset and well-documented profile in both acute and maintenance settings.
Features
- Active ingredient: Prochlorperazine
- Available forms: Tablets, suppositories, injectable solution
- Onset of action: Oral—30–40 minutes; IM—10–20 minutes; Rectal—60 minutes
- Duration: 4–6 hours (oral/IM), up to 12 hours (suppository)
- Prescription-only medication
Benefits
- Provides rapid and effective control of severe nausea and vomiting
- Reduces agitation, hallucinations, and other symptoms of psychosis
- Offers multiple administration routes for flexible clinical use
- Supported by decades of clinical evidence and physician trust
- Can be used in both inpatient and outpatient settings
- Helps restore functional status in acutely ill patients
Common use
Compazine is commonly prescribed for the management of severe nausea and vomiting, including that associated with surgery, cancer chemotherapy, and migraine headaches. In psychiatric practice, it is used to control symptoms of schizophrenia and other psychotic disorders, particularly when accompanied by agitation or nausea. It may also be used as an adjunct in the treatment of non-psychotic anxiety, though this is not a primary indication.
Dosage and direction
For severe nausea/vomiting:
- Adults: 5–10 mg orally 3–4 times daily; 25 mg rectally twice daily; or 5–10 mg IM every 3–4 hours (max 40 mg/day)
- Children (≥2 years, ≥20 lb): 0.4 mg/kg/24 hours orally or rectally in 3–4 divided doses
For psychiatric disorders:
- Adults: 5–10 mg orally 3–4 times daily; may increase gradually to 50–75 mg daily if needed
- Elderly/debilitated patients: Lower initial doses (2.5–5 mg) with gradual titration
Administer with food or milk to minimize gastrointestinal upset. Do not abruptly discontinue after long-term use.
Precautions
Use with caution in patients with cardiovascular disease, glaucoma, prostate hypertrophy, or seizure disorders. May cause drowsiness; advise against operating machinery until response is known. Orthostatic hypotension may occur, particularly with parenteral administration. Neuroleptic malignant syndrome, though rare, requires immediate medical attention. Tardive dyskinesia may develop with prolonged use; periodic reevaluation is recommended. Not recommended for children under 2 years or weighing less than 20 pounds.
Contraindications
Hypersensitivity to prochlorperazine or other phenothiazines. Comatose or severely depressed states. Bone marrow suppression. Concomitant use with large doses of CNS depressants. Should not be used in pediatric surgery or for vomiting of unknown etiology in children.
Possible side effect
Common: Drowsiness, dizziness, blurred vision, dry mouth, constipation. Less common: Orthostatic hypotension, extrapyramidal symptoms (akathisia, dystonia, parkinsonism), neuroleptic malignant syndrome (high fever, muscle rigidity), tardive dyskinesia. Rare: Blood dyscrasias, jaundice, photosensitivity. Contact healthcare provider if experiencing severe side effects or signs of allergic reaction.
Drug interaction
May potentiate effects of CNS depressants (alcohol, opioids, sedatives). Anticholinergic drugs may increase risk of adverse effects. Concurrent use with antihypertensives may potentiate hypotension. May decrease effects of levodopa. Caution with drugs that prolong QT interval. MAO inhibitors may increase sedative and anticholinergic effects.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double doses. If regular dosing schedule is frequently missed, consult healthcare provider about adjusting the regimen.
Overdose
Symptoms may include severe drowsiness, coma, hypotension, extrapyramidal symptoms, agitation, restlessness, convulsions, and cardiac arrhythmias. Treatment is symptomatic and supportive. Maintain airway and administer activated charcoal if recent ingestion. Extrapyramidal symptoms may be treated with diphenhydramine or benztropine. Contact poison control center immediately.
Storage
Store at room temperature (15–30°C/59–86°F) in tightly closed container. Protect from light and moisture. Keep suppositories refrigerated. Do not freeze. Keep all medications out of reach of children and pets.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting or changing any medication regimen. Dosage and indications may vary based on individual patient factors. Compazine requires a prescription and should be used only under medical supervision.
Reviews
“Compazine has been a reliable option in our oncology practice for managing chemotherapy-induced nausea. The multiple formulations allow us to tailor therapy to individual patient needs.” — Oncology Nurse Practitioner, 15 years experience
“In acute psychiatric settings, Compazine provides rapid control of agitation and psychotic symptoms. While we monitor for extrapyramidal effects, its efficacy profile makes it a valuable tool.” — Board-Certified Psychiatrist
“The suppository form has been particularly useful for postoperative patients who cannot tolerate oral medications. Rapid onset and predictable duration make it a staple in our surgical recovery protocol.” — Surgical Clinical Pharmacist