Chlorpromazine

Chlorpromazine is a drug to treat symptoms of psychosis , such as hallucinations and unnatural thoughts, in schizophrenia. This medication is also used for other psychiatric conditions, such as bipolar disorder or severe conduct disorder in children.

Chlorpromazine is a phenothiazine type of antipsychotic drug. This drug works by balancing chemicals in the brain that are generally abnormal in people with mental disorders. This drug can reduce hallucinations, and help patients think more clearly and become less aggressive so that they can carry out their daily activities.

Chlorpromazine also has antiemetic properties so it can be used to relieve nausea and vomiting. In addition, this drug is also the drug of first choice to relieve hiccups that don't stop.

Merek dagang chlorpromazine: Cepezet, Chlorpromazine HCl, Chlorpromazine, Promactil

What is Chlorpromazine

Warning Before Using Chlorpromazine

Chlorpromazine should not be used carelessly. Some things you should pay attention to before using chlorpromazine are:

• Do not use chlorpromazine if you are allergic to this drug or to other phenothiazine antipsychotic drugs, such as thioridazine and perphenazine. Tell your doctor about any allergies you have.
• Tell your doctor if you have a sulfite allergy.
• Tell your doctor if you have or currently have any blood disorders, liver disease, kidney disease, glaucoma , Parkinson's disease, benign prostate enlargement , myasthenia gravis , seizures or epilepsy, intestinal obstruction , breast cancer, or brain tumors .
• Tell your doctor if you have any cardiovascular disease, such as angina pectoris , heart attack, heart failure, arrhythmias , EKG abnormalities , or low blood pressure ( hypotension ). Also tell your doctor if you have a relative who died from sudden cardiac arrest at a young age.
• Tell your doctor if you have or have had any respiratory problems, such as asthma , lung infection, or emphysema .
• Tell your doctor if you have diabetes, hypothyroidism , or a tumor in the adrenal glands ( pheochromocytoma ).
• Do not use chlorpromazine if you have symptoms of psychosis due to dementia .
• Do not use chlorpromazine together with drugs that cause drowsiness or alcoholic beverages, because this can increase the risk of side effects.
• Avoid direct sun exposure, because this drug can make you more sensitive to sunlight.
• Tell your doctor that you are having treatment with chlorpromazine if you are having surgery, including dental surgery.
• Tell your doctor if you are using other medicines, including herbal medicines and supplements, to avoid drug interactions.
• Tell your doctor if you are pregnant, may become pregnant, breastfeeding or planning a pregnancy.
• Do not drive a vehicle or operate equipment that requires caution while having treatment with chlorpromazine, as this medicine may cause dizziness and drowsiness.
• See your doctor immediately if you have an allergic drug reaction , serious side effects, or overdose, after using chlorpromazine.

Dosage and Instructions for Use of Chlorpromazine

The dose of chlorpromazine will be given by the doctor according to the patient's condition. This drug can be given in tablet form, injection through a vein (intravenous/IV), or injection through a muscle (intramuscular/IM). The following is the distribution of chlorpromazine doses based on the patient's age and condition:

Condition: Psychosis or schizophrenia

Chlorpromazine tablet

• Adult: 25 mg 3 times daily or 75 mg once daily at night. The maintenance dose is 25–100 mg, 3 times daily. Dosage can be increased up to 1,000 mg per day. For the elderly, the initial dose is 1/3–1/2 the usual dose.
• Children aged 1–12 years: 0.5 mg/kg, every 4–6 hours. The maximum dose for children aged > 5 years is 75 mg per day and for children aged 1-5 years the maximum dose is 40 mg per day.

Injectable chlorpromazine

• Adults: 25–50 mg every 6–8 hours. For the elderly, the dose is started with 1/3–1/2 of the usual dose. Treatment should be replaced with chlorpromazine tablets as soon as possible after the patient's condition improves.
• Children 1–12 years: 500 mcg/kg every 4–6 hours. Maximum dose for children> 5 years: 75 mg per day, children 1-5 years: 40 mg per day.

Condition: Acute psychosis or manic phase of bipolar disorder

Chlorpromazine tablet

• Adult: 500 mg per day. The maximum dose is 2,000 mg per day. For severe symptoms, the dose is 25–50 mg 3 times daily, given after the patient has received the intramuscular (IM) injectable dose.

Injectable chlorpromazine

• Adult: 25 mg by intramuscular (IM) injection, followed by 25–50 mg every 1 hour. Maintenance dose 400 mg IM every 4–6 hours. For severe symptoms, the dose is 25 mg by intravenous (IV) injection. If needed, the dose can be repeated every 1 hour.

Condition: Aggressive behavior in children

Chlropromazine tablet

• Children 6 months–12 years: 0.55 mg/kg every 4–6 hours.

Injectable chlorpromazine

• Children aged 6 months–12 years: 0.55 mg/kg by intramuscular (IM) injection, given every 6–8 hours.

Condition: Hiccups that won't stop

Chlorpromazine tablet

• Adult: Initially 25–50 mg 3–4 times daily for 2–3 days. If there is no response, treatment can be continued by injecting drugs. For the elderly, the initial dose is 1/3–1/2 the adult dose.
• Children aged 1–12 years: 0.5 mg/kg, every 4–6 hours. The maximum dose for children >5 years is 75 mg per day. As for children 1-5 years the maximum dose is 40 mg per day.

Injectable chlorpromazine

Injection treatment is given if symptoms do not go away after 2-3 days of oral medication.

• Adult: 25–30 mg by intramuscular (IM) injection as a single dose. If it does not improve, it can be given as much as 25-50 mg by slow intravenous (IV) infusion.

Condition:  Nausea and vomiting

Chlorpromazine tablet

• Adult: 10–25 mg every 4–6 hours, until symptoms subside.
• Children aged 1–12 years: 0.55 mg/kg every 4–6 hours, until symptoms subside.

Injectable chlorpromazine

• Adult: 25 intramuscular (IM), followed by 25–30 mg every 3–4 hr until nausea and vomiting stops.
• Children 1–12 years: 0.5 mg/kg intramuscularly (IM) every 4–6 hours. Maximum dose for children> 5 years: 75 mg per day, children 1-5 years: 40 mg per day.

How to use chlorpromazine correctly

Injectable chlorpromazine will be given directly by a doctor or medical officer under the supervision of a doctor. Medicines can be given by injection into a vein (intravenously/IV), by injection through a muscle (intramuscular/IM), or by infusion.

If you are given chlorpromazine to be taken by mouth, always follow your doctor 's advice and read the instructions on the package before using chlorpromazine.

Chlorpromazine tablets can be taken with or without food. Do not crush, chew, or split this medication.

If you forget to take chlorpromazine, take this medicine immediately if it is not close to your next schedule. If it is approaching, ignore the missed dose and do not double the next dose, except as directed by your doctor.

Do not increase your dose, reduce your dose, or stop taking chlorpromazine without consulting your doctor first. Stopping chlorpromazine suddenly can cause withdrawal symptoms, such as nausea, vomiting, or insomnia .

Severe withdrawal symptoms can also cause side effects of extrapyramidal syndrome, which can be characterized by tremors, muscle contractions, or uncontrolled muscle movements, such as eye twitching, blinking, head turning, or sticking out the tongue.

Check with your doctor regularly to monitor the condition. You may be asked to carry out certain medical examinations, such as blood tests, liver function, or routine eye examinations.

Store chlorpromazine in a place away from direct sunlight and out of reach of children.

Chlorpromazine Interactions with Other Drugs

The following are some of the interactions that can occur when chlorpromazine is used with other medicines:

• Increased risk of decreased consciousness to coma, as well as decreased respiratory function, if used with sedatives, sleeping pills, antihistamines , opioid class drugs, anesthetics , or alcoholic beverages
• Increased risk of developing anticholinergic crises, such as dry skin and mouth, facial and neck redness or heat ( hot flashes ), sensitivity to light, fever, and delirium , if used with Parkinson's drugs or tricyclic antidepressants
• Increased risk of orthostatic hypotension when used with MAOI drugs
• Decreased antihypertensive effect of methyldopa , guanethidine, or clonidine drugs

Chlorpromazine Side Effects and Dangers

There are several side effects that can occur after using chlorpromazine, including:

• Drowsiness
• Dry mouth
• Nasal congestion
• Blurred vision
• Constipation
• Impotence
• Difficult orgasm

Consult a doctor if the complaints mentioned above do not go away or get worse. Immediately see a doctor if you experience an allergic drug reaction or more serious side effects, such as:

• Uncontrolled facial muscle movements, such as chewing, tasting, frowning, or blinking
• Difficulty breathing or swallowing, stiff neck, or tight throat
• Dizziness or feeling like you're going to faint
• The body is limp
• Swollen breasts or discharge
• Seizure
• Jaundice, which can be characterized by yellowing of the eyes or skin
• Low levels of white blood cells, which can be characterized by fever, chills, mouth sores, sore throat, cough, or difficulty breathing
• Malignant neuroleptic syndrome, with symptoms of muscle stiffness, high fever, excessive sweating, confusion, irregular heartbeat, or tremors