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.
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...
Clinical Trials Related to Compazine (Prochlorperazine)
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.
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
Staccato Prochlorperazine Thorough QT/QTc Study [Completed]
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
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.
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.
Reports of Suspected Compazine (Prochlorperazine) Side Effects
Drug Hypersensitivity (15),
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
|Overall rating:|| || |
|Effectiveness:|| || Marginally Effective|
|Side effects:|| || Extremely Severe Side Effects|
|Condition / reason:|| || Morning sickness/nausea|
|Dosage & duration:|| || Unknown (dosage frequency: twice) for the period of 1 day|
|Other conditions:|| || Pregnant|
|Other drugs taken:|| || None|
|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
|Overall rating:|| || |
|Effectiveness:|| || Marginally Effective|
|Side effects:|| || Extremely Severe Side Effects|
|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|
|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|
Page last updated: 2011-12-09