Prochlorperazine (Rectal route)

Pronunciation:

proe-klor-PER-a-zeen

Brand Names:

Compazine
Compro
Pms-Prochlorperazine
Stemetil

Dosage Forms:

Suppository

Warnings:

Rectal route(Suppository)

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared with placebo. Although the causes of death in the clinical trials were varied, most deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. It is unclear from these studies to what extent the mortality findings may be attributed to the antipsychotic drug as opposed to the patient characteristics. Prochlorperazine is not approved for the treatment of patients with dementia-related psychosis .

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Phenothiazine

Chemical—

Piperazine (class)

Uses of This Medicine:

Prochlorperazine suppository is used to control severe nausea and vomiting. This medicine should not be used to treat behavioral problems in older adult patients who have dementia.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of prochlorperazine suppository in children 2 years of age and older or weighing 9 kilograms (kg) (20 pounds (lbs)) and over. Use in children younger than 2 years of age or weighing under 9 kg (20 lbs) is not recommended.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of prochlorperazine suppository in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Bromopride
Cisapride
Dofetilide
Dronedarone
Levoketoconazole
Mesoridazine
Metoclopramide
Pimozide
Piperaquine
Potassium Citrate
Saquinavir
Sparfloxacin
Terfenadine
Thioridazine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adagrasib
Alfentanil
Alfuzosin
Alprazolam
Amantadine
Amiodarone
Amisulpride
Amitriptyline
Amoxapine
Anagrelide
Apomorphine
Aprindine
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Asenapine
Astemizole
Atazanavir
Azithromycin
Benzhydrocodone
Bromazepam
Buprenorphine
Bupropion
Buserelin
Butorphanol
Calcium Oxybate
Cannabidiol
Cannabis
Ceritinib
Cetirizine
Chloral Hydrate
Chloroquine
Chlorpromazine
Ciprofloxacin
Citalopram
Clarithromycin
Clobazam
Clofazimine
Clomipramine
Clonazepam
Clothiapine
Clozapine
Codeine
Crizotinib
Dabrafenib
Daridorexant
Dasatinib
Degarelix
Delamanid
Desipramine
Deslorelin
Deutetrabenazine
Dexmedetomidine
Dibenzepin
Dihydrocodeine
Disopyramide
Dolasetron
Domperidone
Donepezil
Doxepin
Doxylamine
Droperidol
Duloxetine
Efavirenz
Encainide
Encorafenib
Enflurane
Entrectinib
Epinephrine
Erythromycin
Escitalopram
Esketamine
Fentanyl
Fexinidazole
Fingolimod
Flecainide
Flibanserin
Fluconazole
Fluoxetine
Formoterol
Foscarnet
Fostemsavir
Gabapentin
Gabapentin Enacarbil
Gatifloxacin
Gemifloxacin
Gepirone
Glasdegib
Glucagon
Glycopyrrolate
Glycopyrronium Tosylate
Gonadorelin
Goserelin
Granisetron
Halofantrine
Haloperidol
Halothane
Histrelin
Hydrocodone
Hydromorphone
Hydroxychloroquine
Hydroxyzine
Ibutilide
Iloperidone
Imipramine
Inotuzumab Ozogamicin
Isoflurane
Isradipine
Ivabradine
Ivosidenib
Ketamine
Ketoconazole
Lacosamide
Lapatinib
Lefamulin
Lemborexant
Lenvatinib
Leuprolide
Levocetirizine
Levofloxacin
Levomethadyl
Levorphanol
Lidoflazine
Lithium
Lofexidine
Lorcainide
Loxapine
Lumefantrine
Macimorelin
Magnesium Oxybate
Mefloquine
Meperidine
Methacholine
Methadone
Metrizamide
Metronidazole
Mifepristone
Mirtazapine
Mobocertinib
Morphine
Morphine Sulfate Liposome
Moxifloxacin
Nafarelin
Nalbuphine
Nilotinib
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Ondansetron
Osilodrostat
Osimertinib
Oxaliplatin
Oxycodone
Oxymorphone
Ozanimod
Pacritinib
Paliperidone
Panobinostat
Paroxetine
Pasireotide
Pazopanib
Pentamidine
Pentazocine
Periciazine
Phenobarbital
Pimavanserin
Pitolisant
Ponesimod
Porfimer
Posaconazole
Potassium Oxybate
Pregabalin
Primidone
Probucol
Procarbazine
Promethazine
Propafenone
Protriptyline
Quetiapine
Quinidine
Quinine
Quizartinib
Ranolazine
Relugolix
Remifentanil
Remimazolam
Revefenacin
Ribociclib
Risperidone
Ropeginterferon Alfa-2b-njft
Scopolamine
Secretin Human
Selpercatinib
Sertindole
Sertraline
Sevoflurane
Siponimod
Sodium Oxybate
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Solifenacin
Sorafenib
Sotalol
Spiramycin
Sufentanil
Sulfamethoxazole
Sulpiride
Sultopride
Sunitinib
Tacrolimus
Tapentadol
Telavancin
Telithromycin
Tetrabenazine
Tiotropium
Topiramate
Toremifene
Tramadol
Trazodone
Triclabendazole
Trifluoperazine
Trimethoprim
Trimipramine
Triptorelin
Vandetanib
Vardenafil
Vemurafenib
Vilanterol
Vinflunine
Voclosporin
Voriconazole
Zolmitriptan
Zolpidem
Zotepine
Zuclopenthixol
Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aminolevulinic Acid
Belladonna
Belladonna Alkaloids
Betel Nut
Evening Primrose
Phenylalanine
Procyclidine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Comatose state (unconscious)—Should not be used in patients with this condition.

Blood or bone marrow problems (eg, agranulocytosis, leukopenia, neutropenia) or
Breast cancer, history of or
Glaucoma or
Liver disease or
Hypotension (low blood pressure) or
Seizures—Use with caution. May make these conditions worse.

Bowel blockage or
Brain tumor or
Reye's syndrome—This medicine may mask symptoms in patients with these conditions.

Dehydration or
Heart disease or
Infections (eg, chickenpox, CNS infection, gastroenteritis, measles) or
Pheochromocytoma (adrenal problem)—May cause side effects to become worse.

Proper Use of This Medicine:

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

Do not take rectal suppositories by mouth or use it in the vagina.

To use the suppository:

If the suppository is too soft to insert, chill it in the refrigerator for 20 to 30 minutes or run cold water over it before removing the wrapper.
Remove the wrapper and moisten the suppository with cool water.
Lie down on your side and use your finger to push the suppository well up into the rectum.
Make sure to wash your hands with soap and water before and after using this medicine.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For rectal dosage form (suppository):
- For severe nausea and vomiting:
  - Adults—25 milligrams (mg) 2 times a day.
  - Children—Use and dose must be determined by your doctor.

Missed dose—

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

Storage—

You may store the suppositories in the refrigerator, but do not freeze them.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor should check the progress of you and your child at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with risperidone may worsen the side effects of this medicine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

This medicine may cause extrapyramidal symptoms. Check with your doctor right away if you have difficulty in speaking, drooling, loss of balance control, muscle trembling, jerking, or stiffness, restlessness, shuffling walk, stiffness of the limbs, twisting movements of the body, or uncontrolled movements, especially of the face, neck, and back.

This medicine may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures or other injuries. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke. Also, use extra care not to become too cold while you are receiving risperidone injection. If you become too cold, you may feel drowsy, confused, or clumsy.

Make sure any doctor or dentist who treats you knows that you are using prochlorperazine suppository. This medicine may affect the results of certain medical tests.

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while using this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Prochlorperazine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known: Agitation; black, tarry stools; chest pain; clay-colored stools; constipation; dark urine; decrease in how much or how often you urinate; diarrhea; difficulty in swallowing and breathing; dizziness, faintness, or lightheadedness when suddenly getting up from a lying or sitting position; drooling; drowsiness; dryness of the mouth; fever and chills; headache; inability to have or keep an erection; loss of appetite; mask-like face; nasal congestion; nausea; painful or difficult urination; shuffling walk; sore throat; sores, ulcers, or white spots on lips or in the mouth; stomach pain; swollen glands; tightness of the throat; trembling and shaking of the fingers and hands; uncontrolled chewing actions and movements of the arms and legs; unpleasant breath odor; unusual bleeding or bruising; unusual tiredness or weakness; vomiting of blood; yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose: Change in consciousness; fast, slow, or irregular heartbeat; loss of consciousness; seizures; severe sleepiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Incidence not known: Blurred vision; increased sensitivity of skin to sunlight; irregular menstrual periods; itching, rash, redness, or discoloration of the skin; jitteriness; trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 11/16/2023

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