Prochlorperazine (Compazine®)- Oral Tablet / IM / IV / Suppository
Pronounce: proe-klor-PER-a-zeen
Classification: Antiemetic, Phenothiazine Derivative; First Generation (Typical) Antipsychotic
About Prochlorperazine (Compazine®)- Oral Tablet / IM / IV / Suppository
Prochlorperazine is a phenothiazine derivative. Phenothiazine derivative medications work by blocking receptors for dopamine (a neurotransmitter) in the brain, helping to reduce or control nausea and/or vomiting. This medication sheet will focus on the use of prochlorperazineas an antiemetic.
How to Take Prochlorperazine
This medication comes in oral, intravenous (IV, into a vein), intramuscular (IM, into a muscle) injection formulations, as well as in rectal suppository form. Prochlorperazine can be given on an as-needed or scheduled basis and should be taken as prescribed by your provider. Your dosage and how you should take your prochlorperazine depends on the cancer treatments you are receiving. If it is being given along with a chemotherapy regimen, it should be given prior to the administration of the chemotherapy. If you are taking prochlorperazine related to side effects of radiation, you should take the medication prior to your treatment. Ask your care team what your dose will be and how often you should take the medication.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed. If you take more than what has been prescribed for you or what is suggested on the product packaging, you should call Poison Control Center at 1-800-222-1222. This medication should not be given to children less than 2 years of age.
Do not drink alcohol while taking prochlorperazine. Avoid driving and doing other tasks that require you to be alert until you know how this medication affects you.
Be sure to tell your provider about all medications and any herbal supplements you take. This medication can interact with many types of medications and supplements, including those that are CNS (central nervous system) depressants, antipsychotics, anti-seizure medications, and anticholinergic agents.
Storage and Handling
All oral and suppository versions of prochlorperazine should be stored in the original, labeled container at room temperature. Keep containers out of reach of children and pets. Dispose of any unused medication safely.
Where Do I Get This Medication?
Some cancer medications are only available through specialty pharmacies. Your provider or pharmacist will start this process. Your insurance plan may also affect where you can get your medication. Call your prescription plan provider to find out which specialty pharmacies are in-network.
Insurance Information
This medication may be covered by your prescription plan. If you qualify, you may be able to get financial help through patient assistance programs (PAP). Co-pay cards may also be available to lower your out-of-pocket cost if you have commercial (not Medicare/Medicaid/Tricare) insurance. Your pharmacist, social worker, or navigator can help find resources for financial support.
Possible Side Effects
These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Risk of Death in Elderly Patients with Dementia
Although rare, there is an increased risk of death in older adults with dementia-related psychosis who are prescribed antipsychotic medications. Since prochlorperazine is also an antipsychotic, patients with dementia-related psychosis should not take this medication.
CNS Effects
This medication affects your brain and central nervous system (CNS). While taking this medication, you may:
- Feel drowsy.
- Have fatigue.
- Feel nervous.
- Have double or blurred vision.
- Feel dizzy.
- Feel weak.
If these side effects make it hard to carry out your daily life, talk with your provider.
If you or your caretaker notice you are having a hard time staying awake, or if you have trouble breathing, call 911 right away.
Anticholinergic Effects
This medication is an anticholinergic. Anticholinergic medications block a neurotransmitter in the brain called acetylcholine. Acetylcholine helps your body contract (tighten) muscles, slow your heart rate, and make secretions (fluids) that are found in your nose, lungs, eyes, mouth, sweat glands, and acid from your stomach. By blocking acetylcholine, this medication can loosen muscles, decrease body secretions (dry them up), and decrease stomach acid.
Because of how this medication works, you may have:
- Dry mouth.
- Constipation.
- Fast heart rate (tachycardia).
- Urinary retention (being unable to pee).
- Blurred vision.
If these side effects make it hard to carry out your daily life, talk with your provider.
Reproductive Concerns
Talk with your provider before trying to get pregnant, getting someone else pregnant, or breastfeeding while receiving this medication.
A Drop in Blood Counts
Your blood counts can drop while taking this medication. Talk with your provider if you have a fever, sudden sore throat, or other signs of infection.
Amenorrhea
Amenorrhea is when your menstrual periods stop. This is usually temporary, meaning your period will likely return. Tell your provider if you miss a menstrual period while on this medication.
Extrapyramidal symptoms
This medication can cause extrapyramidal (neuromuscular) symptoms. Extrapyramidal symptoms affect your motor skills, like how your muscles move, coordination, and strength. Tell your provider if you:
- Feel restless or agitated.
- Have trouble sleeping (insomnia).
- Are unable to control your muscles.
- Have muscle spasms.
- Are having a hard time swallowing.
- Have signs of “pseudoparkinsonism” (flat or mask-like faces, drooling, muscle tremors, pill-rolling motion of fingers, shuffling when walking).
- Have uncontrolled and repetitive movements of your face, tongue, mouth, or jaw (tardive dyskinesia).
Neuroleptic Malignant Syndrome
This medication affects dopamine receptors in your brain. Neuroleptic malignant syndrome is a rare but serious side effect that can be caused when this medication blocks the effects of dopamine in your body. This syndrome can cause:
- Muscle tightness (rigid muscles).
- A change in mental status, such as confusion, agitation, or slowed responses.
- High fever.
- High blood pressure, sweating, or irregular heart rate.
Tell your provider right away if you have any of these symptoms. Tell your provider about all medication and supplements you take, especially antipsychotics (also called neuroleptic medications).