Chlorpromazine

Chlorpromazine is a prescription medication used to treat the symptoms of schizophrenia, mania, and other psychotic disorders. It can also be used to treat severe behavior problems in children. Chlorpromazine can also be used to control nausea and vomiting, as well as pre-operative restlessness and nervousness.

Chrlorpromazine belongs to a group of drugs called conventional antipsychotics. These work by changing the activity of certain natural substances in the brain and other parts of the body.

This medication comes in tablet form and is usually taken 2 to 4 times a day.

This medication is also available in an injectable form to be given directly into a vein (IV) or a muscle (IM) by a healthcare professional.

Common side effects of chlorpromazine include dry mouth, nausea, constipation, and low blood pressure.

Chlorpromazine can also cause drowsiness and dizziness. Do not drive or operate heavy machinery until you know how chlorpromazine affects you.

Oral/Injectable:

Chlorpromazine is a prescription medication used:

• for the management of manifestations of psychotic disorders
• for the treatment of schizophrenia
• to control nausea and vomiting
• for relief of restlessness and apprehension before surgery
• for acute intermittent porphyria
• as an adjunct in the treatment of tetanus
• to control the manifestations of the manic type of manic-depressive illness
• for relief of intractable hiccups
• for the treatment of severe behavioral problems in children (1 to 12 years of age) marked by combativeness and/or explosive hyperexcitable behavior (out of proportion to immediate provocations), and in the short-term treatment of hyperactive children who show excessive motor activity with accompanying conduct disorders consisting of some or all of the following symptoms: impulsivity, difficulty sustaining attention, aggressiveness, mood lability and poor frustration tolerance

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Chlorpromazine may be found in some form under the following brand names:

• Ormazine

• Thorazine

Oral/Injectable:

Serious side effects have been reported with chlorpromazine. See the “Chlorpromazine Precautions” section.

Common side effects of chlorpromazine include the following:

• drowsiness
• blank facial expression
• shuffling walk
• restlessness
• agitation
• nervousness
• unusual, slowed, or uncontrollable movements of any part of the body
• difficulty falling asleep or staying asleep
• increased appetite
• weight gain
• breast milk production
• breast enlargement
• missed menstrual periods
• decreased sexual ability
• changes in skin color
• dry mouth
• stuffed nose
• difficulty urinating
• widening or narrowing of the pupils (black circles in the middle of the eyes)

This is not a complete list of chlorpromazine side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven)
• antidepressants such as amitriptyline, desipramine (Norpramin), imipramine (Tofranil), doxepin (Silenor), fluoxetine (Prozac, Sarafem), sertraline (Zoloft), venlafaxine (Effexor XR), trimipramine (Surmontil), isocarboxazid (Marplan), amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), protriptyline (Vivactil), and clomipramine (Anafranil)
• antihistamines
• atropine (in Motofen, in Lomotil, in Lonox)
• barbiturates such as pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal)
• cancer chemotherapy
• diuretics such as acetazolamide (Diamox), amiloride (Midamor), bumetanide (Bumex), chlorothiazide (Diuril), chlorthalidone (Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide, HCTZ), metolazone (Zaroxolyn), torsemide (Demadex), triamterene (Dyrenium, Dyazide, Maxzide)
• epinephrine (Epipen)
• guanethidine (not available in the US)
• ipratropium (Atrovent)
• lithium (Eskalith, Lithobid)
• medications for anxiety, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, ulcers, or urinary problems
• medications for seizures such as phenytoin (Dilantin)
• narcotic medications for pain
• propranolol (Inderal)
• sedatives
• sleeping pills
• tranquilizers

This is not a complete list of chlorpromazine drug interactions. Ask your doctor or pharmacist for more information.

Oral/Injectable:

Serious side effects have been reported with chlorpromazine including the following:

• fever
• muscle stiffness
• confusion
• fast or irregular heartbeat
• sweating
• yellowing of the skin or eyes
• flu-like symptoms
• sore throat, chills, and other signs of infection
• unusual bleeding or bruising
• neck cramps
• tongue that sticks out of the mouth
• tightness in the throat
• difficulty breathing or swallowing
• fine, worm-like tongue movements
• uncontrollable, rhythmic face, mouth, or jaw movements
• seizures
• blisters
• rash
• hives
• itching
• swelling of the eyes, face, mouth, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
• vision loss, especially at night
• seeing everything with a brown tint

Chlorpromazine can cause drowsiness and dizziness. Do not drive or operate heavy machinery until you know how chlorpromazine affects you.

Do not take chlorpromazine if you:

• are allergic to chlorpromazine or to any of its ingredients
• are allergic to phenothiazines such as fluphenazine, perphenazine, prochlorperazine (Compazine), promethazine (Phenergan), thioridazine, and trifluoperazine
• are comatose
• have consumed large amounts of central nervous system depressants such as alcohol, barbiturates, and narcotics

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of chlorpromazine, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking chlorpromazine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to chlorpromazine or to any of its ingredients
• have or have ever had asthma
• have emphysema (a lung disease that causes shortness of breath)
• have an infection in your lungs or bronchial tubes (tubes that bring air to the lungs)
• have glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision)
• have breast cancer
• have pheochromocytoma (tumor on a small gland near the kidneys)
• have or have had seizures
• have had an abnormal electroencephalogram (EEG; test that records electrical activity in the brain)
• have any condition that affects the production of blood cells by your bone marrow
• have heart disease
• have liver disease
• have kidney disease
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The safe use of chlorpromazine during pregnancy has not been established. Therefore, it is not recommended that the drug be given to pregnant patients except when, in the judgment of the physician, it is essential. The potential benefits should clearly outweigh possible hazards.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Chlorpromazine has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from chlorpromazine, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take chlorpromazine exactly as prescribed.

Oral:

Chlorpromazine comes in tablet form and is usually taken 2 to 4 times daily.

Injectable:

Chlorpromazine is also available in an injectable form to be given directly into a vein (IV) or muscle (IM) by a healthcare professional.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take 2 doses of chlorpromazine at the same time.

Oral/Injectable:

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age

The dose and route of administration of chlorpromazine should be individualized according to the condition being treated, symptom severity, and patient response.

If you take too much chlorpromazine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If chlorpromazine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep this and all medicines out of the reach of children.

Oral:

Store chlorpromazine at room temperature.

Protect from moisture and light.

Injectable:

Store chlorpromazine at room temperature.

Protect from moisture and light. Slight yellowing of the product may occur if it is exposed to light. This will not alter the potency or effectiveness of the medication. However, it should be discarded if marked discoloration is apparent.

WARNING

Increased Mortality in Elderly Patients with Dementia-Related Psychosis

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Chlorpromazine hydrochloride is not approved for the treatment of patients with dementia-related psychosis.