← Search & browse all drugs
NERVOUS SYSTEM › PSYCHOLEPTICS › ANTIPSYCHOTICS › Phenothiazines with aliphatic side-chain
chlorpromazine
N05AA01
Forms & Strengths
- Tablet: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg
- Oral Concentrate: 30 mg/mL, 100 mg/mL
- Injection Solution: 25 mg/mL
- Suppository: 25 mg, 100 mg
Adult Dosing
- Psychotic disorders: Oral 10-25 mg every 4-6 hours, titrate up to several hundred mg/day as needed.
- Psychotic disorders: IM/IV 25-50 mg initially, repeat every 1-4 hours if needed, then switch to oral.
- Nausea and vomiting: Oral 10-25 mg every 4-6 hours.
- Nausea and vomiting: IM/IV 25-50 mg, may repeat in 1 hour if necessary.
- Intractable hiccups: Oral or IM 25-50 mg 3-4 times daily.
Pediatric Dosing
- Children > 6 months (Psychosis/Severe behavioral problems): Oral 0.55 mg/kg every 4-6 hours as needed.
- Children > 6 months (Psychosis/Severe behavioral problems): IM/IV 0.55 mg/kg every 6-8 hours.
- Children > 6 months (Nausea and vomiting): Oral 0.55 mg/kg every 4-6 hours.
- Children > 6 months (Nausea and vomiting): IM/IV 0.55 mg/kg every 6-8 hours.
Indications
- Management of manifestations of psychotic disorders
- Control of nausea and vomiting
- Relief of intractable hiccups
- Preoperative sedation
- Adjunct in the treatment of tetanus
Mechanism of Action
- Low-potency typical antipsychotic that blocks central dopamine receptors (primarily D2)
- Exhibits strong anticholinergic, antihistaminic (H1), and alpha-1 adrenergic blocking activity
- Depresses the reticular activating system, affecting basal metabolism, body temperature, wakefulness, vasomotor tone, and emesis
Contraindications
- Known hypersensitivity to chlorpromazine or other phenothiazines
- Comatose states or severe central nervous system depression
- Concurrent use of large amounts of central nervous system depressants
- Bone marrow suppression or history of drug-induced leukopenia
Adverse Reactions
- Extrapyramidal symptoms including akathisia, dystonia, and tardive dyskinesia
- Sedation, drowsiness, dizziness, and orthostatic hypotension
- Anticholinergic effects such as dry mouth, blurred vision, urinary retention, and constipation
- Prolonged QT interval, arrhythmias, and sudden cardiac death
- Neuroleptic malignant syndrome and hyperprolactinemia
Drug Interactions
- Enhances CNS depression when co-administered with alcohol, opioids, sedatives, or general anesthetics
- Increases risk of QT prolongation with other QT-prolonging agents (e.g., antipsychotics, fluoroquinolones, macrolides)
- Antagonizes the therapeutic effect of dopaminergic agents such as levodopa
- May increase serum concentrations and toxicity of lithium
- Potentiates hypotensive effects of antihypertensive medications
Curated Content: Needs Vetting Before Put to Clinical Use