Prochlorperazine Mesilate
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Generic Name of Prochlorperazine Mesilate - Learn More
Prochlorperazine Mesilate
Prochlorperazine Mesilate Precaution - What You Need to Know
Before using Prochlorperazine Mesilate, it is critical for patients to consult their healthcare provider, especially if they have any of the following conditions or are taking certain medications:
- Central Nervous System (CNS) Disorders: Prochlorperazine is a dopamine antagonist, and it can worsen symptoms of Parkinson’s disease or other CNS disorders, like dementia. Caution is necessary for those with neurological conditions, as it may cause side effects such as sedation or tremors.
- Heart Issues: Patients with heart conditions like arrhythmias, QT prolongation, or heart failure should use prochlorperazine with caution. The drug can affect the heart’s electrical activity and may increase the risk of arrhythmias.
- Glaucoma: The drug has anticholinergic effects, so it should be avoided in individuals with narrow-angle glaucoma or those at risk for developing glaucoma.
- Liver Impairment: Prochlorperazine is metabolized in the liver. Those with liver disease should take this medication with caution, as its metabolism may be impaired, leading to higher drug concentrations.
- Kidney Impairment: If you have renal disease or reduced kidney function, use prochlorperazine carefully, and your doctor may need to adjust the dosage.
- Seizure History: Prochlorperazine may lower the threshold for seizures. Individuals with a history of seizures or epilepsy should be closely monitored.
- Pregnancy and Breastfeeding: Prochlorperazine falls under FDA pregnancy category C, meaning it should be used only if the benefits outweigh the risks. It can also pass into breast milk, so nursing mothers should consult a doctor before use.
- Elderly Patients: Older adults may be more susceptible to the sedative effects, hypotension (low blood pressure), and extrapyramidal symptoms (e.g., tremors or rigidity).
Prochlorperazine Mesilate Indication - Uses and Benefits
Prochlorperazine Mesilate is a dopamine antagonist with both antipsychotic and antiemetic properties. It is indicated for the following conditions:
- Nausea and Vomiting: It is commonly prescribed for controlling nausea and vomiting associated with various conditions, such as chemotherapy, radiation therapy, post-surgery recovery, and other gastrointestinal disturbances.
- Schizophrenia: Prochlorperazine is used in the treatment of schizophrenia and other psychotic disorders, helping manage symptoms like delusions, hallucinations, and disorganized thoughts.
- Vertigo and Dizziness: It is used to alleviate symptoms of vertigo and dizziness, often associated with Meniere's disease or vestibular disorders.
- Severe Anxiety: Sometimes used to manage severe anxiety on a short-term basis, though not typically a first-line therapy.
- Migraine Relief: Prochlorperazine can be used as an adjunct in the treatment of severe migraines, especially to control the nausea and vomiting that often accompany these headaches.
Prochlorperazine Mesilate Contraindications - Important Warnings
Certain conditions and circumstances make the use of Prochlorperazine Mesilate inappropriate or potentially harmful. It should not be used in the following situations:
- Hypersensitivity: Any known allergy or hypersensitivity to prochlorperazine or its ingredients makes its use contraindicated.
- Coma and Severe CNS Depression: Prochlorperazine should not be used in patients who are in a coma or experiencing severe CNS depression, as it can worsen these conditions.
- Severe Liver Impairment: In patients with significant liver dysfunction (such as cirrhosis), prochlorperazine should be avoided due to impaired metabolism and potential for toxicity.
- Blood Disorders: Conditions like bone marrow suppression, leukopenia, or agranulocytosis are contraindications because the drug may further suppress blood cell production.
- Pheochromocytoma: A rare tumor of the adrenal glands, pheochromocytoma, is a contraindication due to the risk of hypertensive crises.
- Prolonged QT Syndrome: Prochlorperazine can prolong the QT interval, and should not be used in patients with congenital prolonged QT syndrome or in those with electrolyte imbalances (like hypokalemia) that predispose them to arrhythmias.
Prochlorperazine Mesilate Side Effects - What to Expect
The side effects of Prochlorperazine Mesilate range from common and mild to rare and severe:
- Common Side Effects:
- Sedation/Drowsiness: Many patients experience drowsiness, especially when starting the medication. It is important to avoid driving or operating machinery until the patient knows how the drug affects them.
- Dizziness: Dizziness, particularly when standing up too quickly (orthostatic hypotension), can occur.
- Dry Mouth: The drug has anticholinergic effects, leading to dry mouth, which may cause discomfort.
- Blurred Vision: Temporary vision disturbances may occur due to the drug's anticholinergic activity.
- Constipation: Commonly occurs due to the reduced motility in the gastrointestinal tract.
- Serious Side Effects:
- Extrapyramidal Symptoms (EPS): These include tremors, muscle rigidity, and bradykinesia (slow movement), and can be more severe in long-term use.
- Neuroleptic Malignant Syndrome (NMS): A rare but serious condition characterized by high fever, muscle rigidity, altered mental status, and autonomic dysregulation (e.g., fluctuating blood pressure and heart rate). It requires immediate medical attention.
- Severe Allergic Reactions: Though rare, patients may experience an anaphylactic reaction, including symptoms like swelling of the face and throat, rash, and difficulty breathing, which requires immediate medical help.
- Cardiac Effects: Prochlorperazine may cause QT prolongation, increasing the risk of arrhythmias and other heart-related issues, especially in those with pre-existing heart conditions or electrolyte imbalances.
Patients should contact their healthcare provider immediately if they experience any of these severe side effects.
Prochlorperazine Mesilate Pregnancy Category ID - Safety Information
3
Prochlorperazine Mesilate Mode of Action - How It Works
Prochlorperazine Mesilate primarily works by blocking dopamine receptors (especially D2 receptors) in the brain. Dopamine is a neurotransmitter involved in mood regulation, motor control, and other vital functions. By inhibiting dopamine activity, prochlorperazine achieves its therapeutic effects:
- Antipsychotic Action: In conditions like schizophrenia, blocking dopamine receptors reduces symptoms such as hallucinations, delusions, and disorganized thoughts.
- Anti-nausea Action: Prochlorperazine acts on the chemoreceptor trigger zone (CTZ) in the brain, which plays a key role in the vomiting reflex. By blocking dopamine in this area, prochlorperazine reduces nausea and vomiting.
- Sedative Effect: It also has sedative effects, which can help alleviate anxiety or restlessness in some patients, especially in the short-term.
- Antiemetic Effect: The drug reduces nausea associated with conditions such as chemotherapy and vertigo.
Prochlorperazine Mesilate Drug Interactions - What to Avoid
Prochlorperazine Mesilate may interact with various other substances, either decreasing its effectiveness or causing harmful side effects. Important interactions include:
- CNS Depressants: When combined with other CNS depressants, such as benzodiazepines, alcohol, or opioids, prochlorperazine may cause excessive sedation, respiratory depression, or even coma.
- Antidepressants: Using prochlorperazine with tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs) can increase the risk of serotonin syndrome, a potentially life-threatening condition.
- Antihypertensive Medications: Prochlorperazine can increase the effect of antihypertensive drugs, leading to hypotension, especially postural hypotension (low blood pressure when standing).
- Levodopa: This Parkinson’s disease drug works by increasing dopamine levels in the brain, and prochlorperazine, which blocks dopamine receptors, can reduce the effectiveness of levodopa, worsening Parkinsonian symptoms.
- Lithium: When used together, prochlorperazine may increase the risk of neurotoxicity from lithium, causing symptoms like confusion, tremors, and seizures.
- Anti-cholinergic Drugs: Using prochlorperazine with other anticholinergic medications (such as antihistamines or atropine) may increase the likelihood of side effects like dry mouth, constipation, and urinary retention.
Prochlorperazine Mesilate Adult Dose - Recommended Dosage
The standard dosage of Prochlorperazine Mesilate depends on the condition being treated:
- For Nausea/Vomiting: The usual dose is 5–10 mg orally, every 6-8 hours as needed, up to a maximum of 40 mg/day.
- For Schizophrenia/Psychotic Disorders: The initial dose is typically 5–10 mg/day, which may be increased to 20–40 mg/day based on the patient's response. The dose is usually divided into 2-3 doses.
- For Anxiety: 5 mg, 2-3 times per day, is typically prescribed for short-term use.
- For Vertigo: The recommended dose is 5–10 mg orally, 3-4 times per day.
Prochlorperazine Mesilate Child Dose - Dosage for Children
In children, Prochlorperazine Mesilate should only be used under medical supervision. The usual dosages are based on age and weight:
- For Nausea/Vomiting: The dose is typically 0.1–0.15 mg/kg per dose, up to 5 mg per dose, every 4–6 hours as needed.
- For Schizophrenia/Psychosis: The dose for children is usually 0.05–0.1 mg/kg/day, divided into 2-3 doses, and adjusted based on clinical response and tolerability.
As with adults, pediatric patients should be monitored for side effects, especially extrapyramidal symptoms or changes in behavior.
Prochlorperazine Mesilate Renal Dose - Dosage for Kidney Conditions
Prochlorperazine Mesilate should be used with caution in patients with renal impairment. Although no specific dosage adjustments are provided for mild to moderate renal dysfunction, the drug should be monitored closely. In severe renal impairment, dose reduction or increased monitoring may be required to avoid accumulation and potential side effects.
