prochlorperazine maleate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
prochlorperazine maleate: clinical details
Prescribing considerations
- Confirm that migraine has previously been medically diagnosed before recommending selected pharmacy products.
- Consider whether vomiting could indicate another disorder because antiemetic action may mask underlying disease.
- Assess cardiac disease, bradycardia, ventricular arrhythmia history, electrolyte disturbance and concurrent QT-prolonging treatment.
- Consider risks of postural hypotension, extrapyramidal reactions, photosensitivity, venous thromboembolism and increased mortality in older people with dementia.
- Selected buccal products contain sugar-derived excipients and may be unsuitable in specified rare hereditary sugar-intolerance disorders.
Contraindications and cautions
- Hypersensitivity to prochlorperazine or an excipient
- Impaired liver function
- Existing blood dyscrasia
- Epilepsy
- Parkinson's disease
- Prostatic hypertrophy
- Narrow-angle glaucoma
- Pregnancy for selected self-care migraine products
Monitoring
- Investigate unexplained fever or infection promptly with a blood count because agranulocytosis is possible.
- Stop and obtain an ECG if symptoms suggest cardiac arrhythmia.
- Assess urgently for neuroleptic malignant syndrome if fever, rigidity, altered consciousness or autonomic instability develops.
- Review for acute dystonia, akathisia, parkinsonism and tardive dyskinesia.
Clinical pharmacology
A piperazine phenothiazine with dopamine-receptor antagonist activity in the chemoreceptor trigger zone. Buccal tablets form a gel against the gum for absorption through the buccal mucosa.
Formulation and product differences
- Selected products are buccal tablets intended to dissolve between the upper lip and gum; they must not be used like conventional swallowed tablets.
- Check product-specific contraindications, age restrictions, excipients, storage instructions and legal category against the individual SmPC.
prochlorperazine maleate preparations and strengths
Buccal tablet
Route: Buccal
Strengths: 3 mg
Tablet
Route: Oral
Strengths: 5 mg
prochlorperazine maleate interactions
Check other medicines with a pharmacist or prescriber because prochlorperazine can increase sedation, alter treatment effects, or raise cardiac and neurological risks.
Alcohol and sedating medicines
May increase drowsiness, impaired alertness and other central nervous system effects.
QT-prolonging medicines
Certain antiarrhythmics, antidepressants, macrolide antibiotics and antipsychotics may increase the risk of dangerous heart-rhythm disturbance.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.