Caution/Monitor.tropisetronMonitor Closely (1)prochlorperazine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.trospium chlorideMonitor Closely (3)trospium chloride decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.valbenazineMonitor Closely (1)valbenazine and prochlorperazine both decrease QTc interval. Use Caution/Monitor.vecuroniumMonitor Closely (3)vecuronium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. vecuronium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.venlafaxineMonitor Closely (2)prochlorperazine and venlafaxine both increase QTc interval. Use Caution/Monitor. venlafaxine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.voriconazoleMonitor Closely (1)prochlorperazine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.vorinostatMonitor Closely (1)vorinostat and prochlorperazine both decrease QTc interval. Use Caution/Monitor.xylometazolineMonitor Closely (2)prochlorperazine, xylometazoline. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. prochlorperazine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbeSerious - Use Alternative (1)yohimbe decreases effects of prochlorperazine by pharmacodynamic antagonism. Contraindicated.yohimbineMonitor Closely (2)prochlorperazine, yohimbine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. prochlorperazine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideMonitor Closely (1)prochlorperazine and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (2)prochlorperazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. prochlorperazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)prochlorperazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.zolpidemMonitor Closely (1)prochlorperazine will increase the level or effect of zolpidem by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Additive effect of decreased alertness and psychomotor performancezotepineMonitor Closely (2)prochlorperazine and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. prochlorperazine and zotepine both increase sedation. Use Caution/Monitor. <1% Insomnia Restlessness (immediate restlessness or agitation may be treated with diphenhydramine 25 mg IV push) Dizziness Anxiety Euphoria Agitation Depression Weakness Headache Cerebral edema Poikilothermia Orthostatic hypotension (after IM injection) Tachycardia ECG changes Anorexia Dyspepsia Constipation Diarrhea Ileus Blood dyscrasia Galactorrhea Gynecomastia Ejaculatory disorder Lens opacities (with prolonged use) Photosensitivity Pruritus Frequency Not Defined Akathisia Sedation Anticholinergic effects Weight gain Oligomenorrhea or amenorrhea Erectile dysfunction Extrapyramidal symptoms (muscle stiffness, dystonia, parkinsonism, tardive dyskinesia) Neuroleptic malignant syndrome (infrequent but serious) Seizure Decreased gag reflex Confusion Hypotension Hypertension Leukopenia Agranulocytosis Cholestatic jaundice Photosensitivity reaction Priapism Hepatotoxicity Black Box Warnings Patients with dementia-related psychosis who are treated with antipsychotic drugs are at an increased risk of death, as shown in short-term controlled trials; the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature This drug is not approved for treatment of patients with dementia-related psychosisContraindications Documented hypersensitivity to phenothiazines Coma, severe CNS depression, concurrent use of large amounts of CNS depressants, poorly controlled seizure disorder, subcortical brain damage Postoperative management of nausea/vomiting following pediatric surgery Children <2 years or weighing <9 kg Cautions Avoid using in children with suspected Reye syndrome Use caution in evere hypertension, severe cardiovascular disease Use with caution in glaucoma, prostatic hypertrophy, stenosing peptic ulcer disease, history of neuroleptic malignant syndrome, Parkinson disease, hypocalcemia, renal/hepatic impairment, history of severe reactions to insulin or electroconvulsive therapy, history of seizures, asthma, respiratory tract infections, cardiovascular disease, myelosuppression Blood dyscrasias including neutropenia, agranulocytosis, and leukopenia reported with use; discontinue therapy at first sign of blood dyscrasias Risk of extrapyramidal symptoms, neuroleptic malignant syndrome, hypotension (may be particularly severe in patients with pheochromocytoma or mitral insufficiency) Esophageal dysmotility/aspiration may occur; use with caution in patients at risk of pneumonia Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia May alter cardiac conduction; life-threatening arrhythmias reported with therapeutic doses May cause anticholinergic effects (constipation, xerostomia, urinary retention, blurred vision); use caution in patients with decreased gastrointestinal motility, paralytic ileus, urinary retention, BPH, xerostomia, visual problems May cause pigmentary retinopathy and lenticular and corneal deposits, especially in prolonged therapy May cause sedation and impair ability to perform tasks which require mental alertness, including operating heavy machinery Use associated with increased prolactin levels In case of severe hypotension, use norepinephrine or phenylepinephrine; do not use epinephrine or dopamine Do not crush extended-release product Avoid SC administration (may cause irritation) Antiemetic effect may obscure toxicity of chemotherapeutic drugs Use may be associated with neuroleptic malignant syndrome; monitor muscle rigidity, mental status changes, fever, autonomic instability May need anticholinergic antiparkinsonian agent to counter extrapyramidal symptoms May impair core body temperature regulation FDA warning regarding off-label use for dementia in elderly Pregnancy category: C Lactation: Phenothiazines may be excreted in breast milk; do not nursePregnancy 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 Antiemetic: Antidopaminergic effect, blocking dopamine receptors in the brain, blocking vagus nerve in GI tract Antipsychotic: Blocking mesolimbic dopamine receptors, and blocking alpha-adrenergic receptors (D1 and D2) in brain Absorption Bioavailability: 12.5% Onset: 10-20 min (IM); 30-40 min (PO); 60 min (PR) Duration: 3-4 hr (PO); 3-12hr (PR); extended-release, 10-12 hr Distribution Vd: 1400-1548 L Metabolism Metabolized by liver Metabolites: N-desmethyl prochlorperazine (active) Elimination Half-life: 6.8-9 hr (PO); 6-10 hr (IV) Dialyzable: No Excretion: Feces (primarily) IV Compatibilities Solution: Compatible with most common solvents Additive: Amikacin, ascorbic acid injection, dexamethasone, dimenhydrinate, erythromycin, ethacrynate, lidocaine, nafcillin, penicillin G potassium (incompatible at higher concentrations), sodium bicarbonate, vitamins B and C Syringe (partial list): Atropine, chlorpromazine, cimetidine, diphenhydramine, fentanyl, glycopyrrolate, hydroxyzine, meperidine, metoclopramide, morphine sulfate (incompatible if phenol present)(?) Y-site (partial list): Calcium gluconate, cisplatin, cladribine, clarithromycin, cyclophosphamide, cytarabine, docetaxel, doxorubicin, doxorubicin liposomal, heparin, linezolid, melphalan, methotrexate, potassium chloride, propofol, teniposide, thiotepa, topotecan, vitamins B and C IV Incompatibilities Additive: Aminophylline, amphotericin B, ampicillin, calcium gluconate(?), chloramphenicol, chlorothiazide, floxacillin, furosemide, hydrocortisone, methohexital, penicillin G sodium, phenobarbital, thiopental Syringe: Dimenhydrinate, hydromorphone(?), ketorolac, midazolam, morphine tartate, pentobarbital, thiopental Y-site: Aldesleukin, allopurinol, amifostine, amphotericin B, aztreonam, bivalirudin, cefepime, etoposide phosphate, fenoldopam, filgrastim, fludarabine, foscarnet, gemcitabine, piperacillin/tazobactam IV Administration Avoid bolus IV push rate should not exceed 5 mg/min For infusion, dilute 20 mg in 1 L of compatible solution; may infuse over 30 minutes Storage Store at room temperature, and protect from light Solution is clear or slightly yellow BRAND FORM. UNIT PRICE PILL IMAGE prochlorperazine edisylate injection- 5 mg/mL vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 5 mg/mL vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialprochlorperazine edisylate injection- 10 mg/2 mL (5 mg/mL) vialCopyright © 2010 First DataBank, Inc.Print Patient Educationprochlorperazine edisylate injection NO MONOGRAPH AVAILABLE AT THIS TIME USES: Consult your pharmacist. HOW TO USE: Consult your pharmacist. SIDE EFFECTS: Consult your 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: Consult your pharmacist. DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. NOTES: No monograph available at this time. MISSED DOSE: Consult your pharmacist. STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised July 2016. Copyright(c) 2023 First Databank, Inc. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. QL Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. ST Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription. OR Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. 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