Chlorpromazine: Uses, Dosage, Side Effects & Interactions

Chlorpromazine: Key Points and Overview

Chlorpromazine is a prescription medication commonly used to treat various mental health conditions, including schizophrenia, bipolar disorder, and severe anxiety. It is also effective in managing nausea, vomiting, and persistent hiccups. Chlorpromazine works by balancing certain chemicals in the brain, which helps improve mood, behavior, and mental clarity. Always consult your healthcare provider before starting or adjusting your dose. If needed, you can schedule a telemedicine appointment with one of our providers for personalized care.

Chlorpromazine: Generic and Brand Names

Generic Name: Chlorpromazine

US Brand Name: Thorazine

The generic name refers to the active ingredient in the medication, while the brand name is the name given by the manufacturer. In this case, Chlorpromazine is the generic name, and Thorazine is the brand name.

Pharmacologic Category of Chlorpromazine

Antipsychotic (First Generation)

Phenothiazine Derivative

Chlorpromazine Dosage Guidelines

Chlorpromazine is prescribed for a variety of conditions, and the dosage will depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. If you need guidance, you can schedule a telemedicine visit with one of our providers.

Chlorpromazine Dosage for Schizophrenia (Adults)

The typical starting dose is 25 mg taken orally three times a day. The dose may be gradually increased based on how well you respond, up to a maximum of 400 mg daily in divided doses. Maintenance doses generally range from 200 to 800 mg per day.

Chlorpromazine Dosage for Bipolar Disorder (Adults)

The usual dose is 25-50 mg taken orally three times a day. The dose may be adjusted based on your response, with a maximum daily dose of 1000 mg.

Chlorpromazine Dosage for Severe Anxiety (Adults)

The typical dose is 10-25 mg taken orally 2-4 times a day. The dose may be increased as needed, but should not exceed 400 mg per day.

Chlorpromazine Dosage for Psychotic Disorders (Adults)

The starting dose is 25 mg taken orally three times a day, with gradual increases as needed, up to a maximum of 1000 mg per day.

Chlorpromazine Dosage for Nausea and Vomiting (Adults)

The usual dose is 10-25 mg taken orally every 4-6 hours as needed, with a maximum daily dose of 100 mg.

Chlorpromazine Dosage for Hiccups (Adults)

The typical dose is 25-50 mg taken orally 3-4 times a day until symptoms resolve.

Chlorpromazine Dosage for Agitation (Adults)

The usual dose is 25-50 mg taken orally every 4-6 hours as needed.

Chlorpromazine Dosage for Delirium (Adults)

The typical dose is 25-50 mg taken orally every 4-6 hours as needed.

Chlorpromazine Dosage for Tourette Syndrome (Adults)

The usual dose is 25-50 mg taken orally 2-4 times a day, with adjustments based on your response.

Chlorpromazine Dosage Forms and Strengths

Tablets: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg

Oral Solution: 30 mg/mL, 100 mg/mL

Injectable Solution: 25 mg/mL

How to Take Chlorpromazine: Administration Instructions

Take Chlorpromazine exactly as prescribed by your healthcare provider. It can be taken with or without food, although taking it with food may help reduce stomach upset. If you are using the oral solution, be sure to measure the dose carefully with a special measuring device or spoon. Avoid using a household spoon, as it may not provide an accurate dose. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Never take two doses at once to make up for a missed dose.

Chlorpromazine Side Effects and Adverse Reactions

Like all medications, Chlorpromazine may cause side effects. Some are more common, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers to discuss your symptoms.

Common Chlorpromazine Side Effects

1. Drowsiness: Feeling unusually sleepy or fatigued.
2. Dry Mouth: A lack of saliva, leading to a dry sensation in the mouth.
3. Constipation: Difficulty or infrequent bowel movements.
4. Blurred Vision: Trouble seeing clearly.

Serious Chlorpromazine Side Effects (Less Common)

1. Tardive Dyskinesia: Involuntary movements of the face and body, which may become permanent.
2. Neuroleptic Malignant Syndrome: A rare but life-threatening reaction that can cause fever, muscle stiffness, and confusion.
3. Severe Allergic Reaction: Symptoms may include rash, itching, swelling, or difficulty breathing.

Chlorpromazine Contraindications

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. It’s important to be aware of these situations to avoid potential risks when taking Chlorpromazine.

Allergy to Chlorpromazine or Other Phenothiazines

If you have had an allergic reaction to Chlorpromazine or similar medications, taking it again could lead to serious allergic reactions, such as rash, swelling, or difficulty breathing.

Severe Liver Disease

Chlorpromazine is processed by the liver. If your liver is not functioning properly, the medication may not be broken down effectively, leading to potentially harmful levels in your body.

Severe Cardiovascular Disease

Chlorpromazine can affect heart rhythm and blood pressure. If you have heart problems, it may increase the risk of complications such as arrhythmias (irregular heartbeats) or low blood pressure.

Bone Marrow Suppression

Chlorpromazine can lower the number of white blood cells, which are essential for fighting infections. If you already have low blood cell counts, taking this medication could increase your risk of infections.

Coma or Severe Central Nervous System Depression

Chlorpromazine can cause drowsiness and sedation. If you are in a coma or have severe central nervous system depression, taking this medication could worsen your condition.

Chlorpromazine Drug Interactions

Chlorpromazine can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It’s essential to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.

1. Levodopa (Sinemet): Chlorpromazine may decrease the effectiveness of Levodopa, a medication used to manage Parkinson’s disease symptoms.
2. Antihypertensive medications: Chlorpromazine can amplify the blood pressure-lowering effects of drugs like Lisinopril (Zestril) or Amlodipine (Norvasc), which may lead to dangerously low blood pressure.
3. Anticholinergic drugs: Medications such as Benztropine (Cogentin) or Oxybutynin (Ditropan) may increase the likelihood of side effects like dry mouth, constipation, and blurred vision when combined with Chlorpromazine.
4. Opioids: Taking Chlorpromazine with opioid pain medications like Hydrocodone (Vicodin) or Oxycodone (OxyContin) can heighten the risk of severe drowsiness, respiratory depression, and overdose.
5. Alcohol: Consuming alcohol while on Chlorpromazine can intensify the sedative effects of the drug, leading to increased drowsiness, dizziness, and a higher risk of accidents.

Chlorpromazine in Pregnancy

Is it safe to take Chlorpromazine during pregnancy?

Chlorpromazine is classified as a pregnancy category C drug by the FDA. This means that there are not enough well-controlled studies in humans to determine its safety during pregnancy. While animal studies have shown some risk to the fetus, the potential benefits of the medication may outweigh the risks in certain situations. If you are pregnant or planning to become pregnant, it’s important to discuss the risks and benefits of Chlorpromazine with your healthcare provider. They can help you make an informed decision about the best treatment plan for your condition.

Chlorpromazine While Breastfeeding

Is it safe to take Chlorpromazine while breastfeeding?

Chlorpromazine can pass into breast milk and may affect a nursing infant. The drug may cause drowsiness, poor feeding, and developmental delays in a breastfed baby. If you are breastfeeding, it’s crucial to talk to your healthcare provider before taking Chlorpromazine. They may suggest an alternative treatment or advise you to stop breastfeeding while using the medication.

Chlorpromazine Cost and Affordability

The cost of a 30-day supply of Chlorpromazine without insurance can vary depending on the dosage and the pharmacy. With a GoodRx coupon, the price for a typical 100 mg dose of Chlorpromazine can range from $15 to $30 for a 30-day supply. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a discount service like GoodRx to find the most affordable option.

Chlorpromazine Alternatives for Various Conditions

For some conditions, alternative treatments or lifestyle changes may be helpful. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss your options.

1. Schizophrenia: Alternatives include other antipsychotic medications like Risperidone (Risperdal) or Olanzapine (Zyprexa). Cognitive behavioral therapy (CBT) and lifestyle adjustments, such as reducing stress and improving sleep, may also help manage symptoms.
2. Bipolar disorder: Mood stabilizers like Lithium or anticonvulsants such as Valproate (Depakote) are commonly used alternatives. Psychotherapy and maintaining a regular routine can also be beneficial.
3. Severe anxiety: Other medications, such as Benzodiazepines (e.g., Lorazepam, Ativan) or SSRIs (e.g., Sertraline, Zoloft), may be prescribed. Relaxation techniques, mindfulness practices, and regular exercise can also help alleviate anxiety symptoms.
4. Psychotic disorders: Other antipsychotics like Quetiapine (Seroquel) or Aripiprazole (Abilify) may be considered. Psychotherapy and support groups can also provide valuable assistance.
5. Nausea and vomiting: Alternatives include medications like Ondansetron (Zofran) or Metoclopramide (Reglan). Staying hydrated and eating smaller, more frequent meals may help reduce nausea.
6. Hiccups: Other treatments include Baclofen or Gabapentin. Simple lifestyle changes, such as drinking cold water or holding your breath, may also help stop persistent hiccups.
7. Agitation and delirium: Alternatives include medications like Haloperidol (Haldol) or Lorazepam (Ativan). Creating a calm and quiet environment can also help reduce agitation.
8. Tourette syndrome: Medications like Clonidine (Catapres) or Guanfacine (Intuniv) are often used. Behavioral therapy, including habit reversal training, may also help manage tics.

Recent Research on Chlorpromazine

Recent studies have explored the potential use of Chlorpromazine in treating COVID-19-related symptoms due to its anti-inflammatory and antiviral properties. While early research has shown some promise, more studies are needed to confirm its effectiveness in this area. Additionally, ongoing research is investigating the long-term effects of Chlorpromazine on cognitive function, particularly in patients with schizophrenia. As always, it’s important to consult your healthcare provider before considering any off-label uses of this medication.

James Kingsley

Learn More