Chlorpromazine Hydrochloride Side Effects
Serious Adverse Side Effects
Chlorpromazine Hydrochloride has some very serious adverse side effects such as:
- Cardiovascular side effects such as prolonged QT intervals, a rare heart condition
- Dermatological side effects such as erythroderma, an inflammatory skin disease
- Gastrointestinal side effects such as severe constipation, and intestinal obstruction
- Hematological side effects such as lowered white blood cell count, aplastic anemia (where the bone marrow doesn’t replenish new blood cells), and leukopenia, (abnormally low white blood cells)
- Hepatic side effects such as jaundice
- Immunological side effects such as anaphylaxis (a serious and deadly allergic skin reaction), systemic lupus erythematosus, a long term immune disorder where healthy tissue is attacked
- Neurological side effects such as twitching, neuroleptic malignant syndrome (a life-threatening neurological disorder), and seizures
- Reproductive side effects such as priapism, in which a sexual organ doesn’t return to its flaccid state
Common Adverse Side Effects
Chlorpromazine Hydrochloride also has some common and less severe adverse side effects associated with it, such as:
- Cardiovascular side effects such as head rush, and abnormal heart rate
- Endocrine metabolic side effects such as ineffective thermoregulation, heatstroke, and hypothermia
- Gastrointestinal side effects such as constipation, nausea and dry mouth
- Neurological side effects such as restless leg syndrome, dizziness, parkinsonism (a condition that mimics Parkinson’s disease), drowsiness, and tardive dyskinesia (a disorder that leads to involuntary and repetitive body movements)
Warnings & Recalls for Chlorpromazine Hydrochloride
Black Box Warning
Chlorpromazine Hydrochloride has a “black box” warning associated with it that imparts to the patient that elderly patients with dementia-related problems who are treated with drugs such as
Chlorpromazine Hydrochloride are at increased risk of death compared with those treated with a placebo.
Contraindications
Chlorpromazine Hydrochloride has got the following contraindications:
- Comatose state
- Concurrent use with large doses of central nervous system depressants
- Hypersensitivity to phenothiazines
Who Should Not Take This Drug
The following patients should never consider taking
Chlorpromazine Hydrochloride:
- Elderly patients with dementia-related psychosis
- Patients with blood disorders
- Bone marrow depression
- Cardiovascular diseases
- Concurrent use with alcohol
- Concurrent use with metrizamide
- Patients with encephalopathic syndrome
- Patients who are exposed to extreme heat
- Patients who are exposed to organophosphorus insecticides
- Patients with glaucoma
- Patients with hepatic encephalopathy due to cirrhosis
- Patients with liver disease
- Patients who have undergone a myelography session within 48 hours
- Patients with neuroleptic malignant syndrome
- Pediatric patients with signs and symptoms of Reye’s syndrome
- Patients with a phenothiazine hypersensitivity
- Patients with a kidney disease
- Patients with respiratory disorders
- Patients who experience seizures
- Patients with sulfite sensitivity
Pregnancy Warning
This drug has an unknown pregnancy rating in the US, however it is worth noting that in Australia it is given a rating of "C". Hence, it is highly advisable that a pregnant patient not consider taking this drug while in pregnancy.
Chlorpromazine Hydrochloride Treatment and Use
Chlorpromazine Hydrochloride is a drug which is used to treat schizophrenia specifically. Its drug classification is that of an antipsychotic. This drug can come in the form of an intramuscular injection or in pill form.
Other uses for this drug include:
- Acute intermittent porphyria
- Presurgical apprehension
- Manic episodes of bipolar disorder
- Intractable hiccups
- Nausea and vomiting
- Severe problematic behavior
- Adjunct tetanus
Chlorpromazine Hydrochloride was first synthesized in December 11, 1950 as the first drug to display antipsychotic actions. The introduction of this drug for clinical use has often been described as the single greatest advance in psychiatric care, dramatically improving the prognosis and diagnosis of patients, and with it came the need to disregard electroconvulsive therapy and psychosurgery, making it one of the driving forces behind the deinstitutionalization of patients.
Check the “Warnings and Precautions” tab to get more information about the “Black Box” warning for this drug.
How This Drug Works
Chlorpromazine Hydrochloride works as a dimethylamine derivative whose mechanism of action is largely unknown. It is a psychotropic agent that produces sedative and antiemetic activities in the central nervous system as well as in many other organ systems. This drug has a weak anticholinergic activity and displays a strong antiadrenergic activity also is in possession of slight ganglionic, antihistaminic and antiserotonin activities.
Dosage Information
The dosage of Chlorpromazine Hydrochloride is dependent upon the nature of the illness. The following are the pediatric and adult dosing of Chlorpromazine Hydrochloride:
For pediatric patients:
- Presurgical apprehension: ORAL 0.25mg/pound of body weight. 2-3 hours before operation
- Presurgical apprehension: INTRAMUSCULAR 0.25mg/pound of body weight. 1-2 hours before operation
- Nausea and vomiting: ORAL 0.25mg/pound of body weight
- Nausea and vomiting: INTRAMUSCULAR 0.25mg/pound of body weight every 6-8 hours as needed
- Problem behaviors (Severe): ORAL (children 6 months – 12 years of age) 0.25mg/pound of body weight every 4-6 hours as needed
- Problem behaviors (Severe): INTRAMUSCULAR (children 6 months – 12 years of age) 0.25mg/pound of body weight every 6-8 hours as needed
- Problem behaviors (Severe): (hospitalized patients ages 6 months – 12 years of age) 50-100mg/day and in older children 200mg/day as needed
- Adjunct tetanus: INTRAMUSCULAR 0.25mg/pound of body weight every 6-8 hours
- Adjunct tetanus: INTRAVENOUS 0.25mg/pound of body weight every 6-8 hours
For adult patients:
- Acute intermittent porphyria: ORAL 25-50mg 3-4 times in a day
- Acute intermittent porphyria: INTRAMUSCULAR 25mg 3-4 times in a day
- Presurgical apprehension: ORAL 25-50mg 2-3 hours before operation
- Presurgical apprehension: INTRAMUSCULAR 12.5-25mg 1-2 hours before operation
- Manic episode bipolar disorder: ORAL 10mg 3-4 times a day or 25mg 2-3 times a day
- Manic episode bipolar disorder: INTRAMUSCULAR 25mg may repeat in 1 hour if needed
- Intractable hiccups: ORAL 25-50mg 3-4 times a day
- Nausea and vomiting: ORAL 10-25mg every 4-6 hours
- Nausea and vomiting: INTRAMUSCULAR 25-50mg every 3-4 hours as needed
- Nausea and vomiting (during surgery): INTRAVENOUS 2mg IV
- Schizophrenia: ORAL 10-25mg (hours depend upon dosage)
- Schizophrenia (Severe): ORAL 25mg 3 times a day
- Schizophrenia: INTRAMUSCULAR 25mg
- Adjunct tetanus: INTRAMUSCULAR 25-50mg 3-4 times a day, usually in conjunction with barbiturates
- Adjunct tetanus: INTRAVENOUS 25-50mg administered at a rate of 1mg/per minute, usually in conjunction with barbiturates
