use caution when operating heavy machinery Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia Antiemetic effect may obscure toxicity of chemotherapeutic drugs Anticholinergic antiparkinsonian agent may be needed to counter EPS Strong anticholinergic agent and alpha blocker Potential for priapism US Food and Drug Administration (FDA) warning regarding off-label use for dementia in elderly (see Black Box Warnings) Pregnancy category: C; neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others necessitating ICU support and prolonged hospitalization Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics [AAP] states that this is "of concern")Pregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Phenothiazine; antagonizes dopamine D2 receptors in brain; depresses release of hypothalamic and hypophyseal hormones; may also depress reticular activating system Absorption Bioavailability: 20%; extensive 1st-pass metabolism Onset: 30-60 min Duration: 4-6 hr; extended release, 10-12 hr Distribution Protein bound: 92-97% Vd: 20 L/kg Metabolism Metabolized by hepatic P450 enzyme CYP2D6 Metabolites: 10-12 different compounds Elimination Half-life: 30 hr Excretion: Urine Direct IV injection is only for control of nausea and vomiting during surgery and for adjunctive treatment of tetanus IV infusion is only for adjunctive treatment of intractable hiccups in adults IV Administration Direct IV injection: Dilute with NS to concentration no higher than 1 mg/mL, and administer at rate of 1 mg/min in adults and 0.5 mg/min in children; avoid administering undiluted drug IV infusion: Add appropriate dose to 500-1000 mL of NS, and administer slowly BRAND FORM. UNIT PRICE PILL IMAGE chlorpromazine oral- 200 mg tabletchlorpromazine oral- 50 mg tabletchlorpromazine oral- 100 mg tabletchlorpromazine oral- 50 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 10 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 100 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 10 mg tabletchlorpromazine oral- 200 mg tabletchlorpromazine oral- 200 mg tabletchlorpromazine oral- 50 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 100 mg/mL liquidchlorpromazine oral- 30 mg/mL liquidchlorpromazine oral- 200 mg tabletchlorpromazine oral- 100 mg tabletchlorpromazine oral- 50 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 50 mg tabletchlorpromazine oral- 10 mg tabletchlorpromazine oral- 10 mg tabletchlorpromazine oral- 100 mg tabletchlorpromazine oral- 10 mg tabletchlorpromazine oral- 25 mg tabletchlorpromazine oral- 200 mg tabletchlorpromazine oral- 100 mg tabletchlorpromazine injection- 25 mg/mL solutionchlorpromazine injection- 25 mg/mL solutionchlorpromazine injection- 25 mg/mL solutionchlorpromazine injection- 25 mg/mL solutionCopyright © 2010 First DataBank, Inc.Select a drug:chlorpromazine oralchlorpromazine injectionPrint Patient Educationchlorpromazine oral CHLORPROMAZINE - ORAL (klor-PRO-muh-zeen) COMMON BRAND NAME(S): Thorazine WARNING: There may be a slightly increased risk of serious, possibly fatal side effects (such as heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor. USES: This medication is used to treat certain mental/mood disorders (such as schizophrenia, psychotic disorders, manic phase of bipolar disorder, severe behavioral problems in children). Chlorpromazine helps you to think more clearly, feel less nervous, and take part in everyday life. It can reduce aggressive behavior and the desire to hurt yourself/others. It may also help to decrease hallucinations (hearing/seeing things that are not there). Chlorpromazine is a psychiatric medication that belongs to the class of drugs called phenothiazine antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.Chlorpromazine is also used to control nausea/vomiting, relieve prolonged hiccups, relieve restlessness/anxiety before surgery, and help treat tetanus. HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually 2-4 times daily.The dosage is based on your medical condition, age, and response to treatment. In children, the dosage is also based on weight. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.If you are using the liquid concentrate form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Mix the prescribed dose in 2 ounces (60 milliliters) or more of liquid or soft foods as directed. Some examples of recommended liquids and soft foods to use for mixing include: tomato or fruit juice, milk, simple syrup, coffee, tea, soda, water, soup, or pudding.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.Although you may notice some medication effects soon after starting, for some conditions, it may take several weeks before you get the full benefit of this drug.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as upset stomach, nausea, vomiting, dizziness, and shakiness. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.Tell your doctor if your condition does not improve or if it worsens. SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, dry mouth, blurred vision, tiredness, nausea, constipation, weight gain, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to decrease these side effects. Tell your doctor right away if you notice any of the following side effects: feelings of anxiety/agitation/jitteriness, drooling/trouble swallowing, restlessness/constant need to move, shaking (tremor), shuffling walk, severe muscle spasms/cramping (such as twisting neck, arching back, eyes rolling up), mask-like expression of the face.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: skin discoloration, eye/vision changes, signs of liver disease (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), signs of infection (such as sore throat that doesn't go away, chills, cough), easy bruising/bleeding, mental/mood changes (such as worsening psychosis, unresponsive/catatonic state).Rarely, this medication may cause face/muscle twitching and uncontrollable movements (tardive dyskinesia). In some cases, this condition may be permanent. Tell your doctor right away if you develop any uncontrollable movements such as lip smacking, mouth puckering, tongue thrusting, chewing, or unusual arm/leg movements.In rare cases, chlorpromazine may increase your level of a certain chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, slow/shallow breathing.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: See also Warning section.Before taking chlorpromazine, tell your doctor or pharmacist if you are allergic to it; or to other phenothiazine drugs (such as perphenazine, thioridazine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, kidney problems, heart problems (such as angina, heart attack, fast/irregular heartbeat), low blood pressure, glaucoma, seizures, enlarged prostate, breathing problems (such as severe asthma, emphysema, lung infections), blood or blood clotting problems (such as low white blood cell count, low platelets, anemia, hemophilia), a certain adrenal gland problem (pheochromocytoma), drug/alcohol/substance use disorder, Parkinson's disease.Chlorpromazine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using chlorpromazine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using chlorpromazine safely.This drug may make you dizzy or drowsy or cause blurred vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery or imaging procedures (such as certain X-rays, CT scans) requiring the use of contrast dye (such as metrizamide), tell your doctor or dentist that you are using this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Children may be more sensitive to the side effects of this drug, especially uncontrolled movements. They may be at greater risk when they are sick (such as having viral infection, dehydration).Older adults may be more sensitive to the side effects of this drug, especially dizziness, lightheadedness, drowsiness, uncontrollable movements, constipation, difficulty urinating, blurred vision,