Compazine







Overview

Compazine, generically known as prochlorperazine, is a phenothiazine medication used to manage severe nausea and vomiting, schizophrenia, and severe anxiety. By blocking dopamine D2 receptors in the brain, it effectively controls gastrointestinal and psychiatric symptoms. Available in oral tablets, rectal suppositories, and injectable forms, Compazine offers flexible administration options tailored to patient needs and symptom severity.

Primary Uses

Compazine is indicated for:

  • Severe Nausea and Vomiting: Relieves symptoms from various causes, such as chemotherapy or postoperative recovery.
  • Schizophrenia: Manages psychotic symptoms like delusions, hallucinations, and disorganized thinking.
  • Severe Anxiety: Provides relief for intense anxiety unresponsive to other treatments.

Key Benefits

  • Effective Symptom Control: Rapidly alleviates nausea, vomiting, and psychotic symptoms.
  • Versatile Applications: Treats both gastrointestinal and psychiatric conditions.
  • Multiple Forms: Available in tablets, suppositories, and injections for flexible administration.

Efficacy

Clinical studies confirm Compazine’s effectiveness in reducing nausea and vomiting, improving comfort in patients with gastrointestinal issues. In psychiatric care, it significantly reduces psychotic symptoms and severe anxiety, enhancing mental health and quality of life.

Safety and Tolerability

Compazine is generally well-tolerated, with common side effects including drowsiness, dizziness, blurred vision, dry mouth, and constipation. Serious side effects, such as extrapyramidal symptoms (EPS), jaundice, low blood pressure, or neuroleptic malignant syndrome (NMS), are rare but require immediate medical attention. Regular monitoring by a healthcare provider is recommended.

Dosage and Administration

Dosage:

  • Oral Tablets: 5–10 mg, three to four times daily.
  • Rectal Suppositories: 25 mg, twice daily.
  • Injections: 2.5–10 mg, administered by healthcare professionals, depending on severity and route.

Administration Tips: Oral tablets can be taken with or without food. Suppositories are inserted rectally, typically twice daily. Injections are given in clinical settings for rapid relief. Adhere to prescribed schedules, with dose adjustments based on response and side effects.

Mechanism of Action

Compazine blocks dopamine D2 receptors in the brain, reducing nausea and vomiting by inhibiting the chemoreceptor trigger zone (CTZ). Its antipsychotic effects balance neurotransmitter activity to alleviate schizophrenia and anxiety symptoms, making it effective for both gastrointestinal and psychiatric conditions.

Composition

Active Ingredient: Prochlorperazine, responsible for therapeutic effects.
Inactive Ingredients:

  • Tablets: May include lactose, magnesium stearate, microcrystalline cellulose.
  • Suppositories: Contain cocoa butter or similar bases for rectal absorption.
  • Injections: Include sodium chloride, water for injection, and preservatives.

Side Effects

Common: Drowsiness, dizziness, blurred vision, dry mouth, constipation.
Serious: Extrapyramidal symptoms (tremors, muscle stiffness), jaundice, low blood pressure, neuroleptic malignant syndrome (high fever, rigidity). Seek immediate medical attention for severe symptoms.

Prevention of Side Effects

Start with the lowest effective dose, avoid alcohol and CNS depressants, stay hydrated, and maintain a fiber-rich diet to reduce constipation. Report unusual symptoms to a healthcare provider promptly for timely management.

Contraindications

Compazine is contraindicated in patients with:

  • Hypersensitivity to prochlorperazine or phenothiazines.
  • Severe liver dysfunction or bone marrow depression.
  • History of blood dyscrasias or neuroleptic malignant syndrome (NMS).
  • Severe CNS depression, including coma.

Use cautiously in patients with cardiovascular disease, glaucoma, urinary retention, or epilepsy.

Warnings and Precautions

Avoid driving or operating machinery due to potential drowsiness. Monitor liver function, blood counts, and neurological status regularly. Inform your healthcare provider of all medications to manage interactions. Report signs of EPS or NMS immediately.

Drug Interactions

Compazine may interact with:

  • CNS Depressants: Increases sedation (e.g., alcohol, sedatives).
  • Anticholinergic Drugs: Enhances effects like dry mouth or constipation.
  • Antihypertensives: Increases risk of low blood pressure.
  • QT-Prolonging Drugs: Heightens risk of cardiac arrhythmias.

Inform your healthcare provider of all medications to avoid interactions.

Overdose

Symptoms include severe drowsiness, dizziness, agitation, confusion, seizures, EPS, respiratory depression, or coma. Seek emergency medical help immediately and monitor vital signs for supportive treatment.

Pharmacokinetics

Absorption: Well-absorbed orally, with peak levels in 1–2 hours; injections provide rapid onset.
Metabolism: Extensively metabolized in the liver via CYP2D6.
Excretion: Metabolites excreted in urine and feces.
Half-Life: Approximately 6–8 hours.

Dosage Forms

Forms: Oral tablets (5 mg, 10 mg), rectal suppositories (25 mg), injectable solutions (various concentrations).
Benefits: Tablets for routine use, suppositories for oral intolerance, and injections for rapid relief in clinical settings.

Pregnancy and Breastfeeding

Compazine (Pregnancy Category C) should only be used if benefits outweigh risks, as fetal safety is not fully established. It is excreted in breast milk, so breastfeeding mothers should consult their healthcare provider.

Storage

Store at 20°C–25°C (68°F–77°F) in a dry, light-protected container, out of reach of children. Suppositories may be refrigerated, and injections should follow manufacturer storage guidelines.

Clinical Evidence

Clinical trials validate Compazine’s efficacy in controlling nausea and vomiting, reducing psychotic symptoms in schizophrenia, and managing severe anxiety, improving patient comfort and mental health outcomes.

Conclusion

Compazine is a versatile and effective medication for severe nausea, vomiting, schizophrenia, and anxiety. Its multiple administration routes and proven efficacy make it a valuable treatment option. Adhere to prescribed dosages, monitor for side effects, and consult healthcare providers regularly for optimal results.