COMPAZINE SUMMARY
COMPAZINE®
brand of
prochlorperazine
antiemetic• antipsychotic • tranquilizer
Compazine (prochlorperazine) is a phenothiazine derivative, present in Compazine tablets and Spansule sustained release capsules as the maleate. Its chemical name is 2-chloro-10-[3-(4-methyl-1-piperazinyl)propyl]-10 H -phenothiazine (Z)-2-butenedioate (1:2).
COMPAZINE (prochlorperazine) is indicated for the following:
For control of severe nausea and vomiting.
For the treatment of schizophrenia.
Compazine (prochlorperazine) is effective for the short-term treatment of generalized non-psychotic anxiety. However, Compazine is not the first drug to be used in therapy for most patients with non-psychotic anxiety, because certain risks associated with its use are not shared by common alternative treatments (e.g., benzodiazepines).
When used in the treatment of non-psychotic anxiety, Compazine should not be administered at doses of more than 20 mg per day or for longer than 12 weeks, because the use of Compazine at higher doses or for longer intervals may cause persistent tardive dyskinesia that may prove irreversible (see WARNINGS).
The effectiveness of Compazine as treatmentfor non-psychotic anxiety was established in 4-week clinical studies of outpatients with generalized anxiety disorder. This evidence does not predict that Compazine will be useful in patients with other non-psychotic conditions in which anxiety, or signs that mimic anxiety, are found (e.g., physical illness, organic mental conditions, agitated depression, character pathologies, etc.).
Compazine has not been shown effective in the management of behavioral complications in patients with mental retardation.
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NEWS HIGHLIGHTS
Published Studies Related to Compazine (Prochlorperazine)
Randomized evaluation of octreotide vs prochlorperazine for ED treatment of migraine headache. [2009.02]
Patients with headaches account for approximately 2% of all ED visits, with migraines being the most common defined primary headache syndrome. Our goals were to evaluate the efficacy of intravenous octreotide (OC) for the treatment of migraines, when compared to standard therapy with prochlorperazine... CONCLUSION: Prochlorperazine was statistically superior to octreotide in clinical success rate and decrease in pain in migraine patients but caused more restlessness and sedation.
Clinical Outcomes of Children Treated with Intravenous Prochlorperazine for Migraine in a Pediatric Emergency Department. [2009.01.14]
Background: Prochlorperazine is the only treatment that has been studied so far in a randomized controlled trial and found to reduce pain at 1 h in children with migraine who presented to an emergency department (ED). Objective: To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED...
Prochlorperazine vs. promethazine for headache treatment in the emergency department: a randomized controlled trial. [2008.10]
Headache is a very common medical complaint. Four to six percent of the population will have a debilitating headache in their lifetime; and 1-2% of all Emergency Department (ED) visits involve patients with headaches... Prochlorperazine was superior to promethazine in the rate of headache reduction and rate of home drowsiness, with similar rates of akathesia, nausea resolution, patient satisfaction, and headache recurrence within 5 days of discharge.
A randomized controlled trial of prochlorperazine versus metoclopramide for treatment of acute migraine. [2008.10]
STUDY OBJECTIVE: We compare prochlorperazine 10 mg intravenously versus metoclopramide 20 mg intravenously for the emergency department (ED) treatment of acute migraine... CONCLUSION: Either prochlorperazine 10 mg intravenously or metoclopramide 20 mg intravenously, combined with diphenhydramine 25 mg intravenously, is an efficacious treatment for ED patients with acute migraine. Three quarters of subjects in both arms would want the same medication for their next migraine.
Prochlorperazine vs. Promethazine for Headache Treatment in the Emergency Department: A Randomized Controlled Trial. [2008.06.04]
Headache is a very common medical complaint. Four to six percent of the population will have a debilitating headache in their lifetime; and 1-2% of all Emergency Department (ED) visits involve patients with headaches... Prochlorperazine was superior to promethazine in the rate of headache reduction and rate of home drowsiness, with similar rates of akathesia, nausea resolution, patient satisfaction, and headache recurrence within 5 days of discharge.
Clinical Trials Related to Compazine (Prochlorperazine)
StaccatoŽ Prochlorperazine for Inhalation in Migraine [Completed]
Staccato Prochlorperazine is being developed to treat patients suffering from acute migraine
headaches. In October 2005, we completed a 75 patient, multi-center, double-blind
placebo-controlled Phase 2A clinical trial in patients suffering from moderate to severe
acute migraine headaches. This Phase 2B clinical trial of Staccato Prochlorperazine has been
initiated to assess the efficacy and safety in outpatients with migraine headache with or
without aura.
Randomized Evaluation of Octreotide Versus Compazine for Emergency Department Treatment of Migraine Headache [Recruiting]
- Headaches are a common complaint presenting to the emergency department (ED),
accounting for 1-2% of all ED visits, with migraines as the second most common primary
headache syndrome. Patients that ultimately present to the ED have failed outpatient
therapy and exhibit severe and persistent symptoms. Treatment options have been
traditionally with a parenteral opiod, generally Demerol. Unfortunately, patients with
chronic painful conditions like migraines have been prone to dependency. In 1986, a
nonopioid, compazine was noted serendipitously to relieve migraine headache pain. 1
Nonopioid regimens have evolved as standard therapy in the treatment of migrainne
headache in the ED. Today, there are a number of nonopioid treatment options, but not
without their own individual concerns. Ergotamine and dihydroergotamine are effective,
but commonly cause nausea and vomiting. Sumatriptan is expensive has recurrence rate,
is ineffective in about 20-30%, and is contra-indicated in patients with cardiac
disease. Metoclopramide, a dopamine receptor antagonist, commonly used as an
anti-emetic agent, has been widely studied for use with acute migraines. Its side
effects include drowsiness and dystonic reactions. Compazine has been successfully used
to treat migraine headaches for the past several decades, and has been accepted as
standard treatment of headaches in the ED. 2 Its side effect profile includes
extrapyramidal effects, dysphoria, drowsiness and akathisias. The ideal medication for
treating headaches would have no addictive properties, few side effects, quick onset,
be highly effective and have a low rate of recurrence. Somatostatin is known to have an
inhibitory effect on a number of neuropetides, which have been implicated in migraine.
Native somatostatin is an unstable compound and is broken down in minutes, but
octreotide, a somatostatin analogue has a longer half life. Intravenous somatostatin
has been shown to be as effective as ergotamine in the acute treatment of cluster
headache. 3 The analgesic effect of octreotide with headaches associated with growth
hormone secreting tumor has been established. 4 Five somatostatin receptors have been
cloned with octreotide acting predominantely on sst2 and sst5. The distribution of sst2
within the central nervous system strongly suggests that this particular somatostatin
receptor has a role in cranial nociception, being highly expressed in the trigeminal
nucleus caudalis and periaqueductal grey. Kapicioglu et. al performed a double blind
study comparing octreotide to placebo in treating migraine. They found there to be a
significantly greater relief of pain with octreotide at 2 and 6 hours compared to
placebo (76% vs 25%, p<0. 02). They noted that 47% of those in the octreotide group had
complete relief compared to no patients in the placebo group. They went on to note that
those patients in the octreotide group had earlier relief of symptoms and no side
effects. The only minor adverse event related to the administration of octreotide was a
local reaction in 3 patients (18%). In a study performed recently in Netherlands, no
clinically relevant changes in vital signs, routine chemistry, and urinalysis were
observed with octreotide use. Electrocardiogram analyses showed no newly occurring or
worsening of known cardiac abnormalities 2 and 24 h after injection with octreotide. 5
Levy et. al also compared octreotide to placebo in a double blinded study but found no
difference. This was a poorly designed study, in that the patients treated themselves
at home with an injection of either placebo or octreotide for 2 episodes of headache
and recorded their level of pain relief at 2 hours. Matharu et. al also performed a
double blind study comparing octreotide to placebo, but looking at cluster headaches
rather than migraines. They found there to be a significant improvement with the use of
octreotide over placebo (52% vs 36%). At Darnall Army Community Hospital the cost of
100 mcg Octreotide and10 mg Compazine, is $10. 46, $2. 02-8. 00, respectively.
Staccato Prochlorperazine Thorough QT/QTc Study [Completed]
Ondansetron vs Prochlorperazine for Nausea and Vomiting in the Emergency Department [Recruiting]
This study will compare the effect of prochlorperazine and ondansetron for the treatment of
nausea and vomiting in the emergency department.
Granisetron, Dexamethasone, Prochlorperazine, Aprepitant, and Palonosetron in Preventing Nausea in Patients Undergoing Chemotherapy for Breast Cancer [Recruiting]
RATIONALE: Antiemetic drugs, such as granisetron, dexamethasone, prochlorperazine,
aprepitant, and palonosetron, may help lessen or prevent nausea. It is not yet known which
combination of antiemetic drugs is more effective in preventing nausea caused by
chemotherapy.
PURPOSE: This randomized phase III trial is comparing different combinations of granisetron,
dexamethasone, prochlorperazine, aprepitant, and palonosetron to see how well they work in
preventing nausea in patients undergoing chemotherapy for breast cancer.
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 1 ratings/reviews, Compazine has an overall score of 1. The effectiveness score is 4 and the side effect score is 2. The scores are on ten point scale: 10 - best, 1 - worst.
| | Compazine review by 20 year old female patient | | | Rating |
| Overall rating: | |   |
| Effectiveness: | | Marginally Effective |
| Side effects: | | Extremely Severe Side Effects | | |
Treatment Info |
| Condition / reason: | | Morning sickness/nausea |
| Dosage & duration: | | Unknown (dosage frequency: twice) for the period of 1 day |
| Other conditions: | | Pregnant |
| Other drugs taken: | | None | | |
Reported Results |
| Benefits: | | None |
| Side effects: | | Psuedo Parkinsons/tardive dyskinesia extreme mucle spasms. It was the most terrifying experience I've ever hard. I was literally launching off the bed and nearly unable to talk. I was 3 months pregnant at the time. |
| Comments: | | It was given to me in the hospital in the form of an injection and they had to administer benadryl to counteract |
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Page last updated: 2009-10-20
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