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Compazine (Prochlorperazine Maleate) - Summary

 
 



WARNING
Increased Mortality in Elderly Patients with Dementia-Related Psychosis

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, com- pared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Compazine ® Prochlorperazine Suppositories USP is not approved for the treatment of patients with dementia-related psychosis (see Warnings).

 

COMPAZINE SUMMARY

Prochlorperazine, a phenothiazine derivative, is designated chemically as 2-Chloro -10- [3-(4-methyl-1-piperazinyl)propyl]phenothiazine.

Prochlorperazine 25 mg suppositories are indicated in the control of severe nausea and vomiting in adults.


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NEWS HIGHLIGHTS

Media Articles Related to Compazine (Prochlorperazine)

New AHS Consensus on Emergency Migraine Management
Source: Medscape Emergency Medicine Headlines [2016.06.17]
Intravenous metoclopramide and prochlorperazine, and subcutaneous sumatriptan, get the highest level of recommendation from a panel on acute treatment of migraine in the emergency department
Medscape Medical News

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Published Studies Related to Compazine (Prochlorperazine)

Randomized Controlled Trial of Ondansetron vs. Prochlorperazine in Adults in the Emergency Department. [2011.02]
OBJECTIVE: To compare the effectiveness of ondansetron and prochlorperazine to treat vomiting. Secondary objectives were the effectiveness of ondansetron and prochlorperazine to treat nausea and their tolerability... CONCLUSION: Prochlorperazine and ondansetron appear to be equally effective at treating vomiting in the emergency department.

Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department. [2010.08]
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... CONCLUSION: There was a treatment failure rate of 14% with the use of prochlorperazine in association with diphenhydramine for severe migraine in children seen in a pediatric ED. Copyright 2010 Elsevier Inc. All rights reserved.

A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department. [2010.07]
STUDY OBJECTIVE: Intravenous (IV) prochlorperazine with diphenhydramine is superior to subcutaneous sumatriptan in the treatment of migraine patients presenting to the emergency department (ED)... CONCLUSION: IV prochlorperazine with diphenhydramine is superior to subcutaneous sumatriptan in the treatment of migraine. Copyright 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

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...

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Clinical Trials Related to Compazine (Prochlorperazine)

Prochlorperazine Versus Acetaminophen, Aspirin, and Caffeine for the Treatment of Acute Migraine [Terminated]
The objective of this randomized, double blind study is to demonstrate that one dose oral "excedrin migraine" (acetaminophen, aspirin and caffeine) is not inferior when compared to one dose of intravenous prochlorperazine for the treatment of acute migraine headaches in the emergency department.

Hydromorphone Versus Prochlorperazine + Diphenhydramine for Acute Migraine [Recruiting]
Opioids are commonly used to treat migraine in North American Emergency Departments. We are comparing efficacy and adverse events of hydromorphone, an opioid, to that of prochlorperazine, a dopamine antagonist with known efficacy in migraine. Prochlorperazine will be combined with diphenhydramine to prevent adverse events.

Prochlorperazine vs Imitrex for Acute Migraine in the Emergency Department [Completed]
ED patients with acute migraine will be randomized to either prochlorperazine and Bendaryl OR imitrex. VAS for pain will be monitored, along with side effects. Primary outcome measure is improvement in pain scales between the groups.

Bioavailability of Prochlorperazine Suppositories, 25 mg [Completed]
The purpose of this study is to compare prochlorperazine plasma concentrations produced after administration of the test formulation with those produced after administration of a marketed reference product.

Ondansetron vs Prochlorperazine for Nausea and Vomiting in the Emergency Department [Completed]
This study will compare the effect of prochlorperazine and ondansetron for the treatment of nausea and vomiting in the emergency department.

more trials >>

Reports of Suspected Compazine (Prochlorperazine) Side Effects

Drug Hypersensitivity (15)Depression (14)Dizziness (10)Nausea (10)Fatigue (9)Stress (9)Dyspnoea (8)Vomiting (8)Cleft Palate (7)Cleft LIP (7)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 2 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

 

Compazine review by 35 year old female patient

  Rating
Overall rating:  
Effectiveness:   Marginally Effective
Side effects:   Extremely Severe Side Effects
  
Treatment Info
Condition / reason:   Headache
Dosage & duration:   Intravenous (dosage frequency: one time) for the period of one time
Other conditions:   Headache, nausea, vomiting
Other drugs taken:   none
  
Reported Results
Benefits:   It did get rid of my headache.
Side effects:   Severe. I started to feel anxiety, then intense panic. I wanted to crawl out of my skin, thought about jumping out the window. Had to constantly talk myself down so that I wouldn't pull my IV out. Told by the doctor this was normal and was released. Paced my house for the next 6 hours until it wore off.
Comments:   none

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Page last updated: 2016-06-17

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