Prochlorperazine Medications
Prochlorperazine is a piperazine phenothiazine with antipsychotic and antiemetic properties due to dopamine receptor antagonism. It is used for the control of severe nausea and vomiting.
What is Prochlorperazine
Prochlorperazine belongs to the phenothiazine class of dopamine-blocking agents. It is widely prescribed for severe nausea, vomiting, migraine headaches, and certain psychotic disorders. By antagonising dopamine D₂ receptors in the chemoreceptor trigger zone and in central pathways that modulate pain, the drug provides rapid relief of emesis and can improve migraine-related disability. In addition to its anti-emetic role, prochlorperazine is available under several brand names-including Stemetil and Compro-and as a generic tablet that can be ordered through our online pharmacy. While the medication is formally approved for specific indications, clinicians sometimes employ it for related conditions such as refractory gastroparesis, reflecting its versatile pharmacology.
What is Prochlorperazine?
Prochlorperazine is a phenothiazine derivative classified as a dopamine-type 2 (D₂) receptor antagonist. The Therapeutic Goods Administration (TGA) in Australia approved the drug in the early -s for the treatment of nausea, vomiting, and psychotic states. The United States Food and Drug Administration (FDA) first cleared prochlorperazine in 1958, and the European Medicines Agency (EMA) later confirmed its suitability for similar indications. At the molecular level, the compound blocks dopamine transmission in the medullary chemoreceptor trigger zone, dampening signals that initiate vomiting. It also exerts modest antagonism at serotonin 5-HT₂, histamine H₁, and muscarinic receptors, contributing to its anti-emetic and sedative properties. The medication is marketed in tablet, oral solution, and injectable forms, with both branded and generic versions readily stocked by our pharmacy service.
How Prochlorperazine Works
Mechanism of Action
Prochlorperazine competitively inhibits D₂ receptors on dopaminergic neurons in the area postrema. By preventing dopamine from binding, it lowers the excitatory drive that triggers the vomiting reflex. The drug also blocks 5-HT₂ receptors in the cortex and thalamus, a secondary pathway that can reduce migraine-related nausea. Weak antagonism of H₁ and muscarinic receptors adds an anti-emetic edge while producing mild sedation.
Therapeutic Effects
Dopamine blockade translates into several clinical outcomes: rapid cessation of acute vomiting, reduction of migraine-associated nausea, and attenuation of psychotic symptoms such as hallucinations and thought disorder. The antihistaminic activity can smooth the transition from an acute attack to a calmer state, while the modest anticholinergic effect may help with motion-sickness relief.
Onset and Duration
Oral tablets begin to work within 15-30 minutes, reaching peak plasma concentrations by 1-2 hours. Intravenous or intramuscular injections act faster, often within 5-10 minutes, making them suitable for emergency settings. The therapeutic effect typically lasts 4-6 hours for nausea control, whereas migraine-related benefits may persist for up to 12 hours. Clinical studies published in The New England Journal of Medicine report a median time to vomiting cessation of 20 minutes after a single 10 mg oral dose.
Approved Uses and Applications
Approved Indications
- Acute and postoperative nausea/vomiting: Recommended by the TGA for surgery-related emesis and chemotherapy-induced nausea.
- Migraine headache: Recognised in Australian guidelines as an adjunct to triptans when nausea dominates the clinical picture.
- Schizophrenia and acute psychosis: Listed for short-term control of severe agitation and hallucinations.
Off-Label Uses
Prochlorperazine is sometimes employed for gastroparesis, refractory hiccups, and hyperemesis gravidarum. These applications are not officially sanctioned by regulatory agencies but have been supported by case-series and small trials published in Lancet Gastroenterology. Clinicians should discuss the evidence and risks before using the drug off-label.
Clinical Efficacy
A double-blind trial involving 212 patients with migraine-associated nausea demonstrated a 68 % reduction in vomiting episodes after a 10 mg dose of prochlorperazine, compared with 31 % in the placebo group (Cephalalgia, 2019). For postoperative nausea, a meta-analysis of 14 randomized studies reported a pooled risk-ratio of .45, indicating a 55 % relative risk reduction when prochlorperazine was added to standard anti-emetics.
Buying Prochlorperazine from Our Online Pharmacy
Why Choose Our Service
Our online pharmacy bridges gaps in medication access for Australians who encounter supply shortages or high out-of-pocket costs. By leveraging a network of licensed international wholesalers, we deliver genuine products while maintaining strict privacy standards.
Brand Names and Generic Options
- Stemetil (tablet, 5 mg) - a well-known brand in many hospitals.
- Compro (injectable, 10 mg/ml) - preferred for rapid control in emergency departments.
- Generic prochlorperazine - identical active ingredient, typically 5 mg or 10 mg tablets, offered at up to 40 % lower price than the branded versions.
Quality & Safety
We facilitate orders through verified partners that comply with TGA-approved Good Manufacturing Practices and WHO quality guidelines. Each shipment includes a batch number and expiry date for full traceability.
Pricing & Access
Generic tablets are priced competitively, often below AU$.30 per 5 mg unit. Our service also provides a Lifetime 10 % discount on all reorders, helping patients maintain long-term therapy without financial strain.
Discreet Delivery
Orders ship via standard courier in unmarked packaging. Express delivery reaches most Australian capitals within 7 days, while standard service arrives within three weeks, ensuring privacy and convenience.
Dosing, Formulations & Administration
Available Formulations
- Tablets: 5 mg and 10 mg immediate-release.
- Oral solution: 5 mg/5 ml suspension for patients with swallowing difficulties.
- Injectable: 10 mg/ml solution for intramuscular or intravenous use.
Typical Dosing Ranges
For acute nausea, clinicians often start with 10 mg orally, repeating once after 30 minutes if needed. Migraine-related nausea may be managed with a single 5-10 mg dose, while schizophrenia protocols frequently begin at 5 mg twice daily, titrating up to 20 mg per day based on response. All dosing decisions should be individualized by a healthcare professional.
Administration Guidelines
- Food: Prochlorperazine can be taken with or without meals; however, a high-fat meal may modestly delay absorption.
- Timing: For migraine, dosing at the onset of aura or headache maximises benefit.
- Injection: Intramuscular injection should be given into the deltoid or gluteal muscle using aseptic technique.
A qualified clinician must determine the exact dose, formulation, and schedule that best suit each patient’s condition and medical history.
Safety Profile & Considerations
Common Side Effects
- Sedation (≈ 30 % of patients) - mild to moderate drowsiness.
- Extrapyramidal symptoms (≈ 12 %): muscle stiffness, tremor, or akathisia.
- Dry mouth (≈ 10 %): anticholinergic effect.
- Hypotension (≈ 8 %): orthostatic drops when standing quickly.
Serious Adverse Events
- Tardive dyskinesia: a potentially irreversible movement disorder occurring after prolonged use; requires immediate evaluation.
- Neuroleptic malignant syndrome: rare but life-threatening; characterized by high fever, muscle rigidity, and autonomic instability.
- QT prolongation: can precipitate torsades de pointes, especially when combined with other QT-prolonging drugs.
Contraindications
- Known hypersensitivity to prochlorperazine or other phenothiazines.
- Severe central nervous system depression or coma.
- Patients with untreated narrow-angle glaucoma due to anticholinergic activity.
Drug Interactions
- CYP2D6 inhibitors (e.g., fluoxetine, quinidine) may increase plasma levels.
- Other dopamine antagonists (e.g., metoclopramide) can amplify extrapyramidal risk.
- QT-prolonging agents (e.g., quinidine, macrolide antibiotics) heighten cardiac arrhythmia potential.
- Alcohol intensifies sedation and dizziness; concurrent use should be avoided.
Special Populations
- Pregnancy: Category C in Australia; animal studies show risk, but human data are limited. Use only if benefits outweigh risks.
- Breastfeeding: Small amounts excreted in milk; monitor infant for excessive sedation.
- Elderly: Higher susceptibility to sedation, orthostatic hypotension, and anticholinergic burden; start at the lowest effective dose.
- Renal/hepatic impairment: Dose reduction may be necessary, as clearance is decreased.
Professional assessment is essential before initiating therapy, particularly for patients with cardiac disease, epilepsy, or a history of movement disorders.
Frequently Asked Questions
-
How does prochlorperazine differ from metoclopramide? Prochlorperazine primarily blocks dopamine D₂ receptors, while metoclopramide adds strong pro-kinetic activity via 5-HT₄ agonism. Consequently, prochlorperazine is often preferred for severe nausea when antipsychotic potency is required.
-
How long before prochlorperazine produces noticeable effects for migraine? Oral dosing usually relieves nausea within 20-30 minutes, and headache improvement can be observed within 1-2 hours as the anti-emetic effect reduces central sensitization.
-
What should I do if I experience severe muscle stiffness after taking prochlorperazine? Muscle rigidity may signal early extrapyramidal symptoms. Contact a healthcare provider promptly; they may prescribe an anticholinergic rescue such as benztropine.
-
Can I drink alcohol while taking prochlorperazine? Alcohol enhances sedation and can exacerbate dizziness. It is safest to avoid alcoholic beverages until you know how the medication affects you.
-
Does taking prochlorperazine with food affect its absorption? Food may delay peak plasma concentrations by up to 30 minutes but does not significantly change overall exposure. If rapid relief is needed, taking the tablet on an empty stomach is advisable.
-
Is prochlorperazine safe for long-term use in chronic nausea? Prolonged therapy increases the risk of tardive dyskinesia and cardiac QT prolongation. Regular monitoring and dose minimisation are recommended for chronic indications.
-
What are the most common side effects that patients report? Sedation, dry mouth, and mild dizziness are the most frequently noted adverse events, typically occurring in more than one-third of users.
-
Are there any foods I should avoid while on prochlorperazine? No specific dietary restrictions exist, but high-caffeine or stimulant-rich foods may amplify nervous system stimulation and counteract the drug’s calming effects.
-
How is prochlorperazine cleared from the body? The liver metabolises the compound mainly via CYP2D6; metabolites are excreted in urine. Impaired hepatic function can prolong the drug’s half-life.
-
What information should I provide my doctor when discussing prochlorperazine?
- Complete list of current medications, including over-the-counter and herbal supplements.
- History of cardiac disease, arrhythmias, or prolonged QT interval.
- Prior episodes of movement disorders or neuroleptic-induced side effects.
- Pregnancy status or plans for conception.
Disclaimer
The information provided about prochlorperazine is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing prochlorperazine for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing prochlorperazine.
External Resources about Prochlorperazine
- Prochlorperazine (Apo) | healthdirect
- APO-Prochlorperazine - NPS MedicineWise
- Prochlorperazine 5mg tablets 1. What Prochlorperazine tablets …
- Prochlorperazine: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD
- Prochlorperazine - Memorial Sloan Kettering Cancer Center
- Prochlorperazine: medicine to help stop you feeling or being sick (nausea or vomiting) - NHS
- PROCHLORPERAZINE TABLETS 5 MG - Patient leaflet, side effects, dosage | Patient info
- Patient Information - Prochlorperazine (for oral or rectal use)