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    DEA Class;  Rx

    Common Brand Names; Thorazine

    • Antipsychotics, Phenothiazine
    Oral and parenteral phenothiazine antipsychotic; potencies of other antipsychotics are compared to oral chlorpromazine 100 mg
    Primarily used as an antipsychotic; occastionally used for presurgical anxiolytic, as an antiemetic, and for treatment of intractable hiccups
    Boxed warning regarding an increased risk of death in elderly patients with dementia

    Indicated for the treatment of schizophrenia.

    For the treatment of nausea/vomiting.
    For the treatment of intractable singultus (hiccups).
    For the treatment of acute intermittent porphyria.
    For the treatment of acute psychosis in acutely agitated schizophrenic patients.
    For the treatment of severe behavioral problems associated with oppositional defiant disorder or other disruptive behavioral disorders, or for attention-deficit hyperactivity disorder (ADHD) in pediatric patients who show excessive motor activity with accompanying conduct disorders.
    For the acute treatment of migraine.
    For the treatment of agitation or delirium in hospitalized patients without underlying psychiatric illness.
    For the treatment of neonatal abstinence syndrome.
    For the treatment of severe behavioral or psychological symptoms of dementia (BPSD).

    Hypersensitivity to phenothiazines

    Coma, severe hypotension, severe central nervous system (CNS) depression, concurrent administration of large amounts of CNS depressants, subcortical brain damage, poorly controlled seizure disorder

    Severe cardiovascular disease


    Extrapyramidal symptoms

    • Akathisia

    • Dystonia

    • Muscle stiffness

    • Neuroleptic malignant syndrome (NMS; infrequent but serious)

    • Parkinsonism

    • Tardive dyskinesia


    • Anticholinergic effects

    • Sedation

    • Weight gain

    • Erectile dysfunction

    • Oligomenorrhea or amenorrhea

    Less common

    • Cerebral edema, orthostatic hypotension (after IM injection), tachycardia

    • Agitation, anxiety, depression, dizziness, euphoria, headache, insomnia, poikilothermia, restlessness, weakness

    • Anorexia, constipation, dyspepsia, ileus

    • Lens opacities (prolonged use)


    • ECG changes

    • Photosensitivity

    • Pruritus

    • Galactorrhea

    • Ejaculatory disorder

    • Diarrhea

    • Blood dyscrasia


    • Seizure

    • Priapism

    • Cholestatic jaundice

    Avoid using in children with suspected Reye syndrome

    Use caution in glaucoma, prostatic hypertrophy, stenosing peptic ulcer disease (PUD), history of NMS, Parkinson disease, hypocalcemia, renal or hepatic impairment, history of severe reaction to insulin or electroconvulsive therapy (ECT), history of seizures, asthma, respiratory tract infection, cardiovascular disease, myelosuppression

    Risk of extrapyramidal symptoms (EPS), NMS, hypotension

    Significant hypotension may occur, especially with parenteral administration; hypotension may be particularly severe in patients with pheochromocytoma or mitral insufficiency; in case of severe hypotension, treat with norepinephrine or phenylepinephrine, and do not use epinephrine or dopamine

    May alter cardiac conduction; life threatening arrhythmias reported with therapeutic doses of phenothiazines; may cause QT prolongation and subsequent torsade de pointes; avoid use in patients diagnosed or suspected congenital long QT syndrome

    May cause anticholinergic effects; use caution in patients with paralytic ileus, gastrointestinal motility, urinary retention, xerostomia, or visual problems

    Agranulocytosis, leukopenia, and neutropenia reported with antipsychotic use; periodic blood count assessment recommended in patients with history of risk factors, including history of drug-induced leuko/neutropenia or preexisting low WBC

    Esophageal dysmotility and aspiration reported with antipsychotic use; use caution in patients at risk of pneumonia

    May cause extrapyramidal symptoms, including akathisia, acute dystonic reactions, and pseudoparkinsonism, and tardive dyskinesia; risk of dystonia greater with increased doses

    Therapy is associated with increased prolactin levels; significance unknown

    May cause pigmentary retinopathy, and lenticular and corneal deposits with prolonged therapy

    May cause orthostatic hypotension; use caution in patients with risk factors, including patients who do not tolerate transient hypotensive episodes such as hypovolemia, cerebrovascular disease, cardiovascular disease, or medicatioin predisposing to hypotension/bradycardia

    May impair physical or mental abilities due to sedating properties; use caution when operating heavy machinery

    Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia

    Antiemetic effect may obscure toxicity of chemotherapeutic drugs

    Anticholinergic antiparkinsonian agent may be needed to counter EPS

    Strong anticholinergic agent and alpha blocker

    Potential for priapism

    US Food and Drug Administration (FDA) warning regarding off-label use for dementia in elderly (see Black Box Warnings)

    Pregnancy category: C; neonates exposed to antipsychotic drugs during 3rd trimester of pregnancy are at risk for EPS or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others necessitating ICU support and prolonged hospitalization

    Lactation: Drug enters breast milk; not recommended (American Academy of Pediatrics [AAP] states that this is “of concern”)


    1000 mg/day PO; up to 2000 mg/day PO for short periods. Debilitated patients require lower total daily dosages.


    1000 mg/day PO. Debilitated patients require lower total daily dosages.


    1000 mg/day PO; up to 2000 mg/day PO for short periods. Debilitated patients require lower total daily dosages.


    5—12 years (weight 22.7—45.5 kg): 100—200 mg/day PO or 75 mg/day IM.
    1—4.9 years (weight < 22.7 kg): 50 mg/day PO or 40 mg/day IM.


    >= 6 months (weight < 22.7 kg): 50 mg/day PO or 40 mg/day IM.

    Chlorpromazine hydrochloride


    • 10mg
    • 25mg
    • 50mg
    • 100mg
    • 200mg

    injectable solution

    • 25mg/mL