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CHLORACTIL is a brand name for Chlorpromazine. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Chlorpromazine is a phenothiazine neuroleptic. It is indicated in the following conditions: Schizophrenia and other psychoses (especially where paranoia is a predominant symptom), mania and hypomania. In anxiety, psychomotor agitation, excitement, violent or dangerously impulsive behaviour. Chlorpromazine may be used…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Dosages should be low to begin with and gradually increased under close supervision until the optimum dosage for the individual is reached. Individuals vary considerably and the optimum dose may be affected by the formulation used.
Dosage of chlorpromazine in schizophrenia, other psychoses, anxiety and agitation etc. s. or 75 mg at bedtime increasing by daily amounts of 25 mg to an effective maintenance dose. This is usually in the range 75 to 300mg daily but some patients may require up to 1 g daily.
Children under 1 year:
Do not use unless risk-benefit ratio has been assessed. 5 mg/kg body weight every 4-6 hours to a maximum recommended dose of 40mg daily. Children 6-12 years: 1/3 - 1/2 adult dose to a maximum recommended dose of 75 mg dally.
Elderly or debilitated patients:
Start with 1/3 - 1/2 usual adult dose with a more gradual increase in dosage. s. s.
Children under 1 year:
No information available.
Children 1-5 years:
No information available.
Children 6-12 years:
No information available.
Elderly or debilitated patients:
As for adults.
Nausea and vomiting of terminal illness:
Adults: 10-25 mg every 4-6 hours.
Children under 1 year:
Do not use, unless risk-benefit ratio has been assessed. 5 mg/kg every 4-6 hours. Maximum daily dosage should not exceed 40 mg. 5 mg/kg every 4-6 hours. Maximum daily dosage should not exceed 75 mg.
Elderly or debilitated patients:
Initially 1/3 - 1/2 adult dose. The physician should then use his clinical judgment to obtain control.
Method of administration:
The following undesired events, listed by body system, have been reported with the following frequency: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
) Parkinsonism (more common in adults and the elderly. It usually develops after weeks or months of treatment) to include tremor, rigidity or other features of Parkinsonism. 4), ST depression, U- Wave and T-Wave changes. Cardiac arrythmias, including Ventricular arrhythmia a-v block, Ventricular fibrillation Ventricular tachycardia Torsade de pointes Cardiac arrest have been reported during neuroleptic phenothiazine therapy, possibly related to dosage.
Pre-existing cardiac disease, old age, hypokalaemia and concurrent tricyclic antidepressants may predispose. 6) Reproductive system and breast disorders Priapism General disorders and administration site conditions Temperature regulation disorder Insomnia Agitation 1 may be seen without evidence of clinical disease 2 particularly at the start of treatment 3 particularly during long term treatment; may occur after the neuroleptic is withdrawn and resolve after reintroduction of treatment or if the dose is increased 4 linked to anticholinergic effects 5 in the anterior segment of the eye caused by accumulation of the drug but generally without any impact on sight 6 A premonitory sign may be a sudden onset of fever after one to three weeks of treatment followed by the development of jaundice.
Chlorpromazine jaundice has the biochemical and other characteristics of obstructive (cholestatic) jaundice and is associated with obstructions of the canaliculi by bile thrombi; the frequent presence of an accompanying eosinophilia indicates the allergic nature of this phenomenon.
Liver injury, sometimes fatal, has been reported rarely in patients treated with chlorpromazine. 4). Cases of hepatocellular, cholestatic and mixed Liver injury, sometimes fatal, has been reported rarely in patients treated with chlorpromazine.
Blood Dyscrasias:
All patients must be advised that, if they experience fever, sore throat or any other infection, they should inform their physician immediately and undergo a complete blood count. Treatment will be discontinued if any marked changes (hyperleucocytosis, granulocytopenia) are observed in the latter.
As agranulocytosis has been reported, regular monitoring of the complete blood count is recommended. 8) and requires immediate haematological investigation.
Neuroleptic malignant syndrome:
Treatment must be interrupted in the event of unexplained hyperpyrexia since this can be one of the signs of neuroleptic malignant syndrome (pallor, hyperthermia, disorders of autonomic function, altered consciousness, muscle rigidity).
Signs of autonomic instability, such as hyperhydrosis and irregular blood pressure, can precede the onset of hyperthermia and as such constitute premonitory signs of this syndrome. While this neuroleptic-related effect can be of idiosyncratic origin, certain risk factors such as dehydration and brain damage would seem to indicate a predisposition.
Chlorpromazine should be avoided in patients with hypothyroidism, phaeochromocytoma, myasthenia gravis and prostate hypertrophy. should be avoided in patients known to be hypersensitive to phenothiazines or with a history of narrow angle glaucoma or agranulocytosis.
Acute withdrawal symptoms, including nausea, vomiting and insomnia, have very rarely have been reported following the abrupt cessation of high doses of neuroleptics. Relapse may also occur, and the emergence of extrapyramidal reactions has been reported.
Therefore, gradual withdrawal is advisable. In schizophrenia, the response to neuroleptic treatment may be delayed. If treatment is withdrawn, the recurrence of symptoms may not become apparent for some time. QT prolongation Neuroleptic phenothiazines may potentiate QT interval prolongation which increases the risk of onset of serious ventricular arrhythmias of the torsade de pointes type, which is potentially fatal (sudden death).
1 • Hypothyroidism • Cardiac failure • Bone marrow depression • Phaechromocytoma • Myastheina gravis • Risk of angle-closure glaucoma. • Risk of urinary retention related to urethroprostatic disorders. • History of agranulocytosis. 5).
6). 4). 5). Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Oral.
4) 7 The development of a metallic greyish-mauve coloration of exposed skin has been noted in some individuals, mainly females, who have received chlorpromazine continuously for long periods (four to eight years). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
e. drug induced) QT prolongation. 8). 5). With the exception of emergencies, it is recommended that the initial work up of patients receiving a neuroleptic should include an ECG. Except under exceptional circumstances, this drug must not be administered to patients with Parkinson’s disease.
5). 8). Venous thromboembolism Cases of venous thromboembolism (VTE) sometimes fatal, have been reported with antipsychotic drugs. Since patients treated with anti-psychotics often present with acquired risk factors for VTE, all possible risk factors for VTE should be identified before and during treatment with Chlorpromazine and preventative measures undertaken.
Stroke:
In randomised clinical trials versus placebo performed in a population of elderly patients with dementia and treated with certain atypical anti-psychotic drugs, a 3- fold increase of the risk of cerebrovascular events has been observed.
The mechanism of such risk increase is not known. An increase in the risk with other anti-psychotic drugs or other populations of patient cannot be excluded. Chlorpromazine should be used with caution in patients with stroke risk factors.
Elderly patients with dementia:
Elderly patients with dementia-related psychosis treated with anti-psychotic drugs are at an increased risk of death. 7 times the risk of death in placebo-treated patients. 6% in the placebo group. , pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional anti-psychotic drugs may increase mortality.
The extent to which the findings of increased mortality in observational studies may be attributed to the anti-psychotic drug as opposed to some characteristic(s) of the patient is not clear. As with all anti-psychotic drugs, Chlorpromazine should not be used alone where depression is predominant.
However, it may be combined with antidepressant therapy to treat those conditions in which depression and psychosis coexist. Chlorpromazine Tablets are not licensed for the treatment of dementia-related behavioural disturbances. Because of the risk of […]