Chlorpromazine hydrochloride

[klor-PROH-mah-zeen] Apo-Chlorpromazine M, Chlorprom M, Chlorpromanyl M, Largactil M, Novo-Chlorpromazine M, Ormazine, Thorazine, Thor-Prom (Rx) Classification: Antipsychotic, dimethylamino-type phenothiazine

See also Antipsychotic Agents, Phen-othiazines.

Action/Kinetics: Has significant antiemetic, hypotensive, and sedative effects; moderate to strong anti-cholinergic effects and weak to moderate extrapyramidal effects. Peak plasma levels: 2-3 hr after both PO and IM administration. t1/2 (after IV, IM): Initial, 4-5 hr; final, 3-40 hr. Extensively metabolized in the intestinal wall and liver; certain of the metabolites are active. Steady-state plasma levels (in psychotics): 10-1,300 ng/mL. After 2-3 weeks of therapy, plasma levels decline, possibly because of reduction in drug absorption and/or increase in drug metabolism.

Uses: Acute and chronic psychoses, including schizophrenia; manic phase of manic-depressive illness. Acute intermittent porphyria. Preanes-thetic, adjunct to treat tetanus, intractable hiccoughs, severe behavioral problems in children, neuroses, and N&V. Treatment of choreiform movements in Huntington's disease. Special Concerns: Use during pregnancy only if benefits outweigh risks. PO dosage for psychoses and N&V has not been established in children less than 6 months of age.

Additional Drug Interactions Epinephrine / Chlorpromazine i peripheral vasoconstriction and may reverse action of epinephrine Norepinephrine / Chlorpromazine i pressor effect and eliminates brady-cardia due to norepinephrine

158 CHLORPROMAZINE

How Supplied: Chlorpromazine: Suppository: 25 mg. Chlorpromazine hydrochloride: Capsule, Extended Release: 30 mg, 75 mg, 150 mg; Con-

■ centrate: 30 mg/mL, 100 mg/mL; Injection: 25 mg/mL; Syrup: 10 mg/5 mL; Tablet: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg

Dosage-

• Tablets, Extended-Release Capsules, Oral Concentrate, Syrup

Psychotic disorders. Adults and adolescents: 10-25 mg (of the base) b.i.d.-q.i.d.; dosage may be increased by 20-50 mg/day q 3-4 days as needed. Or, 30-300 mg (of the base) using the extended-release capsules 1-3 times/day (the 300-mg extended-release capsules are used only in severe neuropsychi-atric situations). Pediatric: 0.55 mg/kg (15 mg/m2) q 4-6 hr. N&V.

Adults and adolescents: 10-25 mg (of the base) q 4 hr; dosage may be increased as needed. Pediatric: 0.55 mg/kg (15 mg/m2) q 4-6 hr.

Preoperative sedation. Adults and adolescents: 25-50 mg (of the base) 2-3 hr before surgery. Pediatric: 0.55 mg/kg (15 mg/m2)

2-3 hr before surgery. Hiccoughs or porphyria.

Adults and adolescents: 25-50 mg (of the base) t.i.d.-q.i.d.

Severe psychoses. Adults: 25-50 mg (of the base) repeated in 1 hr if needed; then, repeat the dose q 3-4 hr as needed and tolerated (the dose may be increased gradually over several days). Pediat-ric, over 6 months: 0.55 mg/kg (15 mg/m2) q 6-8 hr as needed. N&V.

Adults: 25 mg (base) as a single dose; then, increase to 25-50 mg q

3-4 hr as needed until vomiting ceases. Pediatric: 0.55 mg/kg q 6-8 hr as needed.

N&V during surgery. Adults: 12.5 mg (base) as a single dose; repeat in 30 min if needed. Pediatric, 0.275 mg/kg; repeat in 30 min if needed.

Preoperative sedative. Adults: 12.5-25 mg (base) 1-2 hr before surgery. Pediatric: 0.55 mg/kg 1-2 hr before surgery.

Porphyria. Adults: 25 mg (base) q 6-8 hr until client can take PO therapy. Tetanus.

Adults: 25-50 mg (base) t.i.d.-q.i.d. (dose can be increased as needed and tolerated).

N&V during surgery. Adults: 25 mg (base) diluted to 1 mg/mL with 0.9% NaCl injection given at a rate of no more than 2 mg/2 min. Pediatric: 0.275 mg/kg diluted to 1 mg/mL with 0.9% NaCl injection given at a rate of no more than 1 mg q 2 min. Tetanus.

Adults: 25-50 mg (base) diluted to 1 mg/mL with 0.9% NaCl injection and given at a rate of 1 mg/min. Pediat-ric: 0.55 mg/kg diluted to 1 mg/mL with 0.9% NaCl injection and given at a rate of 1 mg/2 min.

Adults and adolescents: 50-100 mg q 6-8 hr as needed up to a maximum of 400 mg/day. Pediatric: 1 mg/kg q 6-8 hr as needed (do not use the 100-mg suppository in children).

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