Chlorpromazine Hydrochloride

Chlorpromazine Hydrochloride is a medicine used to treat various disorders such as schizophrenia and other psychoses like paranoia (delusions and feeling extremely worried or nervous), mania (overactive behavior), anxiety, agitation, and dangerously impulsive behavior. Chlorpromazine Hydrochloride is also used for controlling intractable hiccups, feeling or being sick (nausea), and autism (learning and communication difficulties). This medicine belongs to a group of drugs known as phenothiazines, which act on the central nervous system. It alters the thoughts and elevates the mood, improving the person's ability to think, feel and behave. Chlorpromazine Hydrochloride may be taken with or without food, preferably at the same time each day. Take this medicine in the dose and duration as advised by your doctor. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms. Some common side effects of this medicine include dry mouth, abnormality of voluntary movements, urinary retention, constipation, and muscle rigidity.

Chlorpromazine Hydrochloride is a typical antipsychotic. It works by blocking the action of dopamine, a chemical messenger in the brain that affects thoughts and mood.

• Schizophrenia and other psychoses (especially paranoid)
• Mania and hypomania
• Anxiety, psychomotor agitation, excitement, violent or dangerously impulsive behavior
• Intractable hiccup
• Nausea and vomiting of terminal illness
• Childhood schizophrenia and autism

Chlorpromazine acts as an antagonist (blocking agent) on different postsynaptic receptors - on dopaminergic-receptors (subtypes D1, D2, D3 and D4), on serotonergic-receptors (5-HT1 and 5-HT2), on histaminergic-receptors (H1-receptors), alpha1/alpha2-receptors and on muscarinic (cholinergic) M1/M2-receptors. Additionally, Chlorpromazine is a weak presynaptic inhibitor of Dopamine reuptake.

Chlorpromazine is a neuroleptic that acts by blocking the postsynaptic dopamine receptor in the mesolimbic dopaminergic system and inhibits the release of hypothalamic and hypophyseal hormones. It has antiemetic, serotonin-blocking, and weak antihistaminic properties and slight ganglion-blocking activity.

Adult Dose (Schizophrenia, Psychosis - Oral): Initial: 30-75 mg/day divided q6-12hr; Maintenance: usually 200 mg/day (up to 800 mg/day in some patients; some may require 1-2 g/day).

Adult Dose (Parenteral): 25 mg initially, then 25-50 mg after 1-4 hours, then up to 400 mg q4-6hr until controlled; usual 300-800 mg/day.

Nausea & Vomiting: Oral: 10-25 mg q4-6hr; Parenteral: 25-50 mg q4-6hr.

Preoperative Apprehension: 25-50 mg PO (2-3 hours before) or 12.5-25 mg IM (1-2 hours before).

Intractable Hiccups: 25-50 mg PO q6-8hr; if persists after 2-3 days, 25-50 mg IM q3-4hr; if persists, slow IV infusion.

Pediatric Dose (>6 months): Behavioral disorders: 50-100 mg/day; Nausea: 0.5-1 mg/kg q6-8hr; Preoperative: 0.55 mg/kg 1-2 hours before surgery. <6 months: Safety and efficacy not established.

Elderly: Initial: 1/3-½ of normal adult dose.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Chlorpromazine Hydrochloride may be taken with or without food, but it is better to take it at a fixed time. Take it at night to avoid feeling sleepy during the day.

If you miss a dose of Chlorpromazine Hydrochloride, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Sleepiness
• Orthostatic hypotension
• Dry mouth
• Abnormality of voluntary movements
• Weight gain
• Increased prolactin level
• Urinary retention
• Constipation
• Muscle stiffness

Rare Side Effects: Nasal congestion, blurred vision, nausea, libido changes, gynecomastia, skin/corneal pigmentation, photosensitivity, blood dyscrasias, leukopenia, eosinophilia, ECG changes, cholestatic jaundice, QT prolongation, lowered seizure threshold.

• [UNSAFE] Chlorpromazine Hydrochloride may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
• Take it at night to avoid sleepiness during the day.
• Do not stop suddenly without talking to your doctor.
• Do not drink alcohol as it can cause serious breathing problems.
• Inform your doctor if you notice involuntary muscle movements.
• Monitor your weight during treatment.
• Rise slowly if you have been sitting or lying down.

• Hypersensitivity to phenothiazines.
• Comatose states or presence of large amounts of CNS depressants (alcohol, barbiturates, narcotics, etc.).
• Blood dyscrasias, severe liver disease.

Potentiation of anticholinergic effects of antiparkinson agents and TCAs may lead to anticholinergic crisis. Additive orthostatic hypotensive effect with MAOIs. Reverses antihypertensive effect of guanethidine, methyldopa and clonidine. Additive depressant effect with sedatives, hypnotics, antihistamines, general anaesthetics, opiates and alcohol.

Decreased chlorpromazine levels: Food, alcohol, benztropine, antacids, lithium, barbiturates.

Increased chlorpromazine levels: Tricyclic antidepressants, CYP1A2 inhibitors (ciprofloxacin, fluvoxamine, oral contraceptives).

[UNSAFE] It is unsafe to consume alcohol with Chlorpromazine Hydrochloride.

[CONSULT YOUR DOCTOR] Chlorpromazine Hydrochloride may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor. Pregnancy Category C.

[CONSULT YOUR DOCTOR] Chlorpromazine Hydrochloride is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby. If given, monitor the baby for excessive sleepiness during breastfeeding.

Pediatric dose (>6 months): Usual single dose: 0.5 mg/kg (oral) q4-6hr; usual daily dose: 40 mg for a 5-year-old, 75 mg for 5-12 years; psychiatric patients may require gradually increased doses. <6 months: Safety and efficacy not established.

The elderly are relatively more susceptible to the adverse effects of chlorpromazine. Starting dose should be about half the usual adult dose and dosage increments should be gradual and reviewed regularly.

[SAFE IF PRESCRIBED] Chlorpromazine Hydrochloride is safe to use in patients with kidney disease. No dose adjustment is recommended. However, inform your doctor if you have any underlying kidney disease. Close monitoring is advisable.

[CONSULT YOUR DOCTOR] There is limited information available on the use of Chlorpromazine Hydrochloride in patients with liver disease. Please consult your doctor.

Overdose symptoms: Severe extrapyramidal reactions, hypotension, sedation, coma, seizures, ECG changes. Treatment is symptomatic and supportive.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Chlorpromazine Hydrochloride