Chlorpromazine

Administration

• Type: Antipsychotic, first generation
• Dosage Forms: 25mg/mL IV solution; 25mg/5 mL oral solution; 10, 25, and 100mg tablets
• Routes of Administration: PO, IM, IV
• Common Trade Names: Thorazine

Adult Dosing

Nausea/vomiting

• Oral: 10 to 25mg every 4 to 6 hours as needed. May increase, if necessary.
• IM: 25mg one time. If no hypotension occurs, give 25 to 50mg every 3 to 4 hours as needed, then switch to oral dosage.
• IV: 2mg at 2 minute intervals. Do not exceed 25mg. Dilute to 1mg/mL.

Hiccups

• Oral: 25 to 50mg 3 to 4 times a day
• IM: If symptoms persist for 2 to 3 days, give 25 to 50mg IM
• IV infusion: Should symptoms persist, use slow IV infusion: 25 to 50mg in 500 to 1000 mL of saline.

Psychosis

• IM: Initial Dose 25 to 50mg. The dose may be repeated in one hour. Subsequent doses may be increased and given every 2 to 4 hours as needed.
• Oral: Initial Dose: 10 to 25mg orally 3 times a day. Total daily doses should be increased in 20 to 50mg increments every 3 or 4 days until symptoms are controlled.
• Usual Maintenance Dose: 200mg/day orally

Pediatric Dosing

should not be used in children under 6 months

Nausea/vomiting

• Oral: 0.5 to 1mg/kg/dose every 4 to 6 hours as needed.
• IM or IV: 0.5 to 1mg/kg/dose every 6 to 8 hours

Maximum recommended doses

• less than 5 years (less than 22.7 kg): 40mg/day
• 5 and older (22.7-45.5 kg): 75mg/day

Special Populations

• Pregnancy Rating: C
• Lactation risk: drug is excreted in breast milk; patients should discuss with physician risks/benefits if breastfeeding

Indications

• Nausea/vomiting
• intractable hiccups
• psychosis

Contraindications

• Allergy to class/drug

Adverse Reactions

• Extrapyramidal reactions (e.g., Parkinson-like symptoms, dystonia, akathisia, tardive dyskinesia), drowsiness, dizziness, skin reactions or rash, dry mouth, orthostatic hypotension, amenorrhea, galactorrhea, weight gain.

References

1. Chlorpromazine. Retrieved from http://www.drugs.com/cdi/chlorpromazine.html
2. US National Library of Medicine. Chlorpromazine: MedlinePlus Drug Information. Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682040.html.
3. P Young. The ICU Drug Manual. Chlorpromazine. Retrieved from http://lifeinthefastlane.com/book/critical-care-drugs/chlorpromazine/

Authors

Nicole Zadzilka, Ross Donaldson, Neil Young, Daniel Ostermayer