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|Chlorpromazine

Chlorpromazine

Generic name:
Brand names: Chlorpromazine

Why is Chlorpromazine prescribed?

Chlorpromazine is used for the treatment of schizophrenia (severe disruptions in thought and perception). It is also prescribed for the short-term treatment of severe behavioral disorders in children, including explosive hyperactivity and combativeness; and for the manic phase of bipolar disorder.

Chlorpromazine is also used to control nausea and vomiting, and to relieve restlessness and apprehension before surgery. It is used as an aid in the treatment of tetanus, and is prescribed for uncontrollable hiccups and acute intermittent porphyria (attacks of severe abdominal pain sometimes accompanied by psychiatric disturbances, cramps in the arms and legs, and muscle weakness).

Most important fact about Chlorpromazine

Chlorpromazine may cause tardive dyskinesia--a condition marked by involuntary muscle spasms and twitches in the face and body. This condition may be permanent, and appears to be most common among the elderly, especially women. Ask your doctor for information about this possible risk.

How should you take Chlorpromazine?

If taking chlorpromazine in a liquid concentrate form, you will need to dilute it with a liquid such as a carbonated beverage, coffee, fruit juice, milk, tea, tomato juice, or water. Puddings, soups, and other semisolid foods may also be used. Chlorpromazine will taste best if it is diluted immediately prior to use. You should not take chlorpromazine with alcohol.

Do not take antacids such as Gelusil at the same time as chlorpromazine. Leave at least 1 to 2 hours between doses of the two drugs.

--If you miss a dose...

If you take chlorpromazine once a day, take the dose you missed as soon as you remember. If you do not remember until the next day, skip the dose, then go back to your regular schedule.

If you take more than 1 dose a day, take the one you missed as soon as you remember if it is within an hour or so of the scheduled time. If you do not remember until later, skip the dose, then go back to your regular schedule.

Never take 2 doses at once.

--Storage instructions...

Store away from heat, light, and moisture. Do not freeze the liquid. Since the liquid concentrate form of chlorpromazine is light-sensitive, it should be stored in a dark place, but it does not need to be refrigerated.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Chlorpromazine.

• More common side effects may include:
  Constipation, drowsiness, dry mouth, involuntary muscle spasms and twitches (tardive dyskinesia), jaundice, low blood pressure, low white blood cell count, movements similar to Parkinson"s disease, neuroleptic malignant syndrome (see "Special warnings about Chlorpromazine"), rapid heartbeat, restlessness, vision problems

Why should Chlorpromazine not be prescribed?

You should not be using chlorpromazine if you are taking substances that slow down mental function such as alcohol, barbiturates, or narcotics.

You should not take chlorpromazine if you have ever had an allergic reaction to any major tranquilizer containing phenothiazine.

Special warnings about Chlorpromazine

You should use chlorpromazine cautiously if you have ever had: asthma; a brain tumor; breast cancer; intestinal blockage; emphysema; the eye condition known as glaucoma; heart, kidney, or liver disease; respiratory infections; seizures; or an abnormal bone marrow or blood condition; or if you are exposed to pesticides or extreme heat. Be aware that chlorpromazine can mask symptoms of brain tumor, intestinal blockage, and the neurological condition called Reye"s syndrome.

Stomach inflammation, dizziness, nausea, vomiting, and tremors may result if you suddenly stop taking chlorpromazine. Follow your doctor"s instructions closely when discontinuing chlorpromazine.

Chlorpromazine can suppress the cough reflex; you may have trouble vomiting.

This drug may impair your ability to drive a car or operate potentially dangerous machinery. Do not participate in any activities that require full alertness if you are unsure about your ability.

This drug can increase your sensitivity to light. Avoid being out in the sun too long.

Chlorpromazine can cause a group of symptoms called Neuroleptic Malignant Syndrome, which can be fatal. Seek medical help immediately if you develop any of the following symptoms: extremely high body temperature, rigid muscles, mental changes, irregular pulse or blood pressure, rapid or irregular heartbeat, excessive sweating, and high fever.

If you are on chlorpromazine for prolonged therapy, you should see your doctor for regular evaluations, since side effects can get worse over time.

Possible food and drug interactions when taking Chlorpromazine

If chlorpromazine is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining chlorpromazine with the following:

Anesthetics
Antacids such as Gelusil
Antiseizure drugs such as Dilantin
Antispasmodic drugs such as Cogentin
Atropine (Donnatal)
Barbiturates such as phenobarbital
Blood-thinning drugs such as Coumadin
Captopril (Capoten)
Cimetidine (Tagamet)
Diuretics such as Dyazide
Epinephrine (EpiPen)
Guanethidine
Lithium (Lithobid, Eskalith)
MAO inhibitors (antidepressants such as Nardil and Parnate)
Narcotics such as Percocet
Propranolol (Inderal)

Extreme drowsiness and other potentially serious effects can result if chlorpromazine is combined with alcohol and other mental depressants such as narcotic painkillers like Demerol.

Because chlorpromazine prevents vomiting, it can hide the signs and symptoms of overdose of other drugs.

Special information if you are pregnant or breastfeeding

The effects of chlorpromazine during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor. Pregnant women should use chlorpromazine only if clearly needed.

Chlorpromazine appears in breast milk and may affect a nursing infant. If Chlorpromazine is essential to your health, your doctor may advise you not to breastfeed until your treatment is finished.

Recommended dosage

Dosage recommendations shown here are for the oral and rectal forms of the drug. For certain problems, chlorpromazine is also given by injection.

ADULTS

Schizophrenia and Mania

Your doctor will gradually increase the dosage until symptoms are controlled. You may not see full improvement for weeks or even months.

Initial dosages may range from 30 to 75 milligrams daily. The amount is divided into equal doses and taken 3 or 4 times a day. If needed, your doctor may increase the dosage by 20 to 50 milligrams at semiweekly intervals.

Nausea and Vomiting

The usual tablet dosage is 10 to 25 milligrams, taken every 4 or 6 hours, as needed.

One 100-milligram suppository can be used every 6 to 8 hours.

Uncontrollable Hiccups

Dosages may range from 75 to 200 milligrams daily, divided into 3 or 4 equal doses.

Acute Intermittent Porphyria

Dosages may range from 75 to 200 milligrams daily, divided into 3 or 4 equal doses.

CHILDREN

Chlorpromazine is generally not prescribed for children younger than 6 months.

Severe Behavior Problems, Nausea, and Vomiting

Dosages are based on the child"s weight.

Oral: The daily dose is one-quarter milligram for each pound of the child"s weight, taken every 4 to 6 hours, as needed.

Rectal: the usual dose is one-half milligram per pound of body weight, taken every 6 to 8 hours, as necessary.

OLDER ADULTS

In general, older people take lower dosages of chlorpromazine, and any increase in dosage will be gradual. Because of a greater risk of low blood pressure, your doctor will watch you closely while you are taking chlorpromazine. Older people (especially older women) may be more susceptible to tardive dyskinesia--a possibly permanent condition characterized by involuntary muscle spasms and twitches in the face and body. Consult your doctor for information about these potential risks.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of chlorpromazine can be fatal. If you suspect an overdose, seek medical help immediately.

• Symptoms of chlorpromazine overdose may include:
  Agitation, coma, convulsions, difficulty breathing, difficulty swallowing, dry mouth, extreme sleepiness, fever, intestinal blockage, irregular heart rate, low blood pressure, restlessness