Prochlorperazine (Compazine®)- Oral Tablet / IM / IV / Suppository

Author: OncoLink Team
Last Reviewed: July 8, 2020

Pronounced: 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 with reducing or controlling nausea and/or vomiting. This medication sheet will focus on the use of prochlorperazineas an antiemetic.

How This Medication Comes

This medication comes in oral, intravenous (IV, into a vein), intramuscular (IM, into a muscle) injection formulations, as well as in rectal suppository form.

How to Take Prochlorperazine

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 prochlorperazinerelated 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 or actions that call for you to be alert until you know how this medication affects you.

Be sure to tell your healthcare 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?

Prochlorperazine is available through retail/mail order pharmacy.  Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution.  

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources, if they are available.

Possible Side Effects of Prochlorperazine

This medication is given to manage and/or prevent side effects of your cancer treatment. If you are having side effects from this medication you should talk to your team about if this medication is necessary to your treatment or if there are other options to help manage the side effect this medication is treating. These are some of the most common side effects:

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.

Central Nervous System (CNS) Effects

Because of how this medication works and its effects on neurotransmitters in the brain, prochlorperazine may cause drowsiness, fatigue, feeling nervous, blurred or double vision, dizziness, and weakness. If these effects make it hard to carry out daily life, talk with your provider.

Anticholinergic Effects

Because of how prochlorperazine works, it can cause constipation, dry mouth, blurred vision, or urinary retention. These side effects may be worse if you are elderly and/or are on other medications with similar effects. If these effects make it hard to carry out daily life, talk with your provider.

Low Blood Pressure (Hypotension)

Prochlorperazine may cause low blood pressure, especially in patients who have certain heart problems. Get up slowly when standing from a sitting or sleeping position to avoid low blood pressure. Let your care team know if you are having symptoms of low blood pressure which may include dizziness, lightheadedness, or blurred vision. 

Less common, but important side effects can include:

  • A drop in Blood Counts: A drop in your white blood cells can occur with prochlorperazine. This agent may not be used if white blood cell count drops due to an unknown reason. Talk with your care team if you have sudden appearance of sore throat or other signs of infection.   
  • Amenorrhea: This medication may cause menstrual periods to stop, which is usually not permanent. Talk with your care team if you stop having your menstrual period while taking this medication.
  • Extrapyramidal symptoms: There is the risk of certain side effects with prochlorperazine that affect the neuromuscular system and include restlessness, agitation, insomnia, dystonia (abnormal and uncontrollable tightness of muscles), spasms, difficulty swallowing or breathing, “pseudoparkinsonism” (mask-like faces, drooling, tremors, pill-rolling motion of fingers, shuffling), and tardive dyskinesia (rhythmic and uncontrollable movements of the face, tongue, mouth, or jaw). If you think you are having some of these symptoms, call your provider right away.
  • Neuroleptic malignant syndrome: A rare, but serious side effect, called neuroleptic malignant syndrome can occur. This can involve changes in your mental status, fever, or muscle stiffness. This usually happens in combination with certain antipsychotic drugs. If you think you are having some of these symptoms, call your provider right away. 

Reproductive Concerns 

You should consult with your healthcare team prior to becoming pregnant, fathering a child or breastfeeding while receiving this medication.

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