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CHLORPROMAZINE 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 and is indicated in the following conditions. 1. Psychotic conditions (especially paranoid) including schizophrenia, mania and hypomania. 2. As an adjunct in the short term management of anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour.…
Verbatim from this product's MHRA label. Tap a section to expand.
Method of Administration:
Tablets are to be taken orally with a drink of water.
Posology:
Dosage: Dosage varies both with the individual and with the purpose for which the drug is being used. The dosage should be low to begin with and increased, gradually, under close supervision until the optimum level of control is achieved.
Dosage in Schizophrenia, Other Psychoses Anxiety and Agitation etc:
Adults: Initially 25mg three times daily or 75mg at bedtime, increasing by daily amounts of 25mg to the effective maintenance dose. 0g daily.
Children: (i) Aged under 1 year:
Chlorpromazine should generally not be used unless the need is life-saving. 5mg/kg every 4 to 6 hours to a maximum daily dosage of 40mg. (ii) Age 6 to 12 years: One-third to half the adult dose to a maximum daily dosage of 75mg.
Elderly or Debilitated Patients:
Initially one-third to half the usual adult dose with a more gradual increase in dosage.
Dosage in Hiccup:
Adults: 25-50mg three to four times daily Children: No information available.
Elderly:
One-third to half adult dose initially, with a more gradual increase in dosage.
Dosage in Nausea and Vomiting of Terminal Illness:
Adults: ½ to 1 tablet every 4 to 6 hours Children: (i) Age under 1 year: Chlorpromazine should generally not be used unless the need is life-saving. 5mg/kg every 4 to 6 hours. The maximum daily dosage should not exceed 40mg. 5mg/kg every 4 to 6 hours.
The maximum daily dosage should not exceed 75mg.
Elderly or Debilitated Patients:
Initially one-third to half the adult dose. The subsequent dosage should be adjusted under close supervision to obtain control.
Minor side effects include nasal stuffiness, dry mouth, insomnia and agitation. Cardiovascular hypotension, especially postural, is relatively common and elderly patients or subjects with volume depletion are particularly susceptible.
Cardiac arrhythmias have been reported in patients receiving neuroleptic agents and may be dose-related. They include atrial arrhythmia, A-V block, ventricular tachycardia and fibrillation. Pre-existing cardiac disease, hypokalaemia, concurrent use of tricyclic antidepressants and old age may predispose to development of arrhythmia.
ECG changes may occur, including widened QT interval, ST depression, U waves and T wave changes. Cases of venous thromboembolism, including cases of pulmonary embolism and cases of deep vein thrombosis have been reported with antipsychotic drugs-Frequency unknown.
Blood:
Mild leucopenia may occur in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely and is not dose-related. Unexplained infections or pyrexia require immediate haematological investigations.
Respiratory:
Clinical doses of the neuroleptics usually have little effect on respiration. However, respiratory depression may occur in susceptible patients.
Hepatic:
A very small percentage of patients may develop jaundice, which is usually transient and which may be preceded by sudden pyrexia after one to three weeks of treatment. The jaundice is obstructive in type and is frequently accompanied by an eosinophilia, indicating the allergic nature of the event.
Chlorpromazine therapy should be withdrawn if jaundice occurs.
Extrapyramidal:
Chlorpromazine should be avoided whenever possible in patients with hepatic or renal dysfunction, cardiac failure, phaeochromocytoma, hypothyroidism, bone marrow depression, epilepsy, parkinsons' disease, myasthenia gravis, prostatic hypertrophy or a history of narrow angle glaucoma.
Chlorpromazine should be used with caution in the elderly, especially during very hot or very cold weather because of the risk of hyper or hypothermia. Cases of venous thromboembolism (VTE) have been reported with antipsychotic drugs.
Since patients treated with antipsychotics often present with acquired risk factors for VTE, all possible risk factors for VTE should be identified before and during treatment with Chlorpromazine Tablets and preventive measures undertaken.
Increased Mortality in Elderly people with Dementia Data from two large observational studies showed that elderly people with dementia who are treated with antipsychotics are at a small increased risk of death compared with those who are not treated.
There are insufficient data to give a firm estimate of the precise magnitude of the risk and cause of the increased risk is not shown. Chlorpromazine Tablets are not licensed for the treatment of dementia-related behavioural disturbances.
Chlorpromazine is contraindicated in patients with a known hypersensitivity to the drug. Chlorpromazine is also contraindicated in comatose patients, including those under the influence of alcohol or other central nervous system depressants.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Acute dystonic or dyskinetic reactions may occur. These are usually transitory, are more common in children and young adults and are more likely to occur within the first four days of treatment or after dosage increases. Akathisia may occur, characteristically following large initial doses.
Neutoleptic-induced parkinsonism is more common in adults and the elderly and usually takes weeks or months of treatment to develop. Tremor is a common sign but rigidity, akinesia or other features of parkinsonism may also occur. If tardive dyskinesia occurs, it is usually, although not always, associated with prolonged or high dosage.
It may occur after treatment has been discontinued. To reduce the likelihood of tardive dyskinesia, the dosage should be kept low whenever possible.
Skin & Eyes:
Various skin rashes may occur during therapy with Chlorpromazine. Photosensitivity eruptions may occur and patients receiving high dosage should be advised to avoid exposure to direct sunlight. Contact skin sensitisation is a rare but serious complication in persons who frequently handle Chlorpromazine preparations and particular care should be taken to avoid contact of the drug with the skin.
Ocular changes and a metallic greyish-mauve discoloration of exposed skin has been reported in some patients, mainly females, who received Chlorpromazine continuously for long periods of between four and eight years.
Endocrine:
Hyperprolactinaemia has been reported and may result in galactorrhoea, gynaecomastia or amenorrhoea, impotence has been reported.
Neuroleptic Malignant Syndrome:
The syndrome may occur with use of any neuroleptic agent. Symptoms include clouding of consciousness, rigidity and other extrapyramidal effects, and autonomic dysfunction, most importantly hyperpyrexia. Treatment involves the immediate cessation of neuroleptic therapy and symptomatic management as appropriate.
6) . The frequency of this adverse drug reaction is not known.