
Compazine (prochlorperazine) is an antipsychotic medication belonging to the phenothiazine class, primarily used to treat nausea and vomiting, schizophrenia, and anxiety. It works by blocking dopamine receptors in the brain, which helps alleviate symptoms associated with these conditions, including nausea, agitation, and hallucinations (related to CNS).
As a dopamine antagonist, it reduces excessive dopamine activity, which is often linked to psychotic symptoms and nausea. However, it also comes with a range of common side effects, including drowsiness, blurred vision, constipation, dry mouth, dizziness, and restlessness. More serious side effects can include muscle spasms, tardive dyskinesia, and neuroleptic malignant syndrome.
In some cases, patients may experience irregular menstrual periods, impotence, or psychomotor agitation, especially at higher doses. It’s important for patients to be monitored for side effects, particularly with long-term use.
Key Takeaways
Common side effects include drowsiness, blurred vision, constipation, dry mouth, dizziness, restlessness, and in some cases, more serious effects like muscle spasms, tardive dyskinesia, and neuroleptic malignant syndrome.
Most side effects, such as drowsiness and constipation, are typically temporary and may last for a few days to weeks. However, more serious effects like tardive dyskinesia can develop with prolonged use and may become permanent.
There is evidence suggesting that women may experience side effects such as irregular menstrual periods and impotence more frequently than men, while the elderly may be more vulnerable to severe side effects like neuroleptic malignant syndrome and orthostatic hypotension due to age-related physiological changes.
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Compazine (Prochlorperazine) Side Effects
Based on this study, titled "A comparison of the clinical efficacy and safety of prochlorperazine and placebo in the treatment of nausea and vomiting," prochlorperazine (Compazine) is associated with a variety of side effects.
Side Effect | Percentage of Patients Impacted |
Drowsiness (Sedation) | 25-30% |
Dizziness | 10-20% |
Xerostomia (Dry mouth) | 10-20% |
Constipation | 10-15% |
Blurred vision | 5-15% |
Nausea | 5-10% |
Psychomotor agitation | 5-10% |
Drooling | 5-10% |
Irregular menstrual periods | 5-10% |
Impotence | 3-8% |
Nasal Congestion | 3-8% |
Dysphagia (Difficulty swallowing) | 3-5% |
Headache | 5-10% |
Loss of appetite | 5% |
Fever | <5% (rare but serious) |
Hives (Allergic reaction) | <5% (rare) |
Uncontrolled muscle movements | <5% (rare, extrapyramidal symptoms) |
Melena (Dark stools) | <5% (rare, can indicate bleeding) |
Chest pain | <5% (rare, serious) |
Dark urine | <5% (rare, can indicate liver issues) |
Diarrhea | <5% |
Jitteriness | <5% |
Low blood pressure | <5% |
Common Side Effects
Here are common side effects with Compazine (prochlorperazine):
Blurred vision: A relatively common effect due to the anticholinergic properties of Compazine, which can impair the ability to focus.
Dizziness: Seen in a subset of patients, often due to the drug’s sedative properties or its effects on the vestibular system.
Xerostomia (dry mouth): A result of the drug’s anticholinergic action, which reduces saliva production.
Constipation: Another result of anticholinergic activity, reducing motility in the gastrointestinal system.
Drowsiness: Sedation is one of the most commonly noted effects due to Compazine’s central nervous system depressant properties.
Irregular menstrual periods: Related to the dopamine-blocking properties, which can affect hormonal balance and menstrual cycles.
Psychomotor agitation: Often seen in some patients, particularly when the drug disrupts normal dopamine transmission.
Little or no urination: Caused by the drug’s anticholinergic properties, which can inhibit normal urination.
Nasal congestion: Another result of the drug’s anticholinergic action, affecting mucous membranes.
Dysphagia (difficulty swallowing): A less common side effect, but can occur due to neurological side effects affecting the muscles involved in swallowing.
Impotence: Prochlorperazine can interfere with sexual function, likely due to its dopamine-blocking effects.
Nausea: Although used to treat nausea, it can paradoxically induce nausea in some patients, particularly during early treatment or high doses.
Drooling: Linked to excessive salivation in some patients, possibly due to the drug’s impact on central nervous system regulation.
Serious or Less Common Side Effects
Here are less common side effects with Compazine (prochlorperazine):
Fever: Can occur, sometimes due to an allergic reaction or as a side effect of neuroleptic malignant syndrome, which is a rare but serious reaction to antipsychotic medications like Compazine.
Headache: A fairly common side effect, likely related to the sedative effects of the drug and the resulting changes in neurotransmitter activity.
Hives: An allergic reaction, presenting as rash or welts on the skin, often seen in patients who are sensitive to prochlorperazine.
Loss of appetite: This can occur in some patients, possibly linked to the drug’s gastrointestinal side effects or its effects on dopamine levels.
Uncontrolled muscle movements (extrapyramidal symptoms): Including tremors, rigidity, and akathisia, these are common with dopamine antagonists like prochlorperazine, which can lead to motor function disturbances.
Melena (dark, tarry stools): Can indicate gastrointestinal bleeding, which is a more serious and uncommon side effect.
Chest pain: A potential side effect, especially if the patient develops a rare condition like neuroleptic malignant syndrome.
Dark urine: Can be a sign of hemolysis or liver problems, though it’s less common.
Diarrhea: A potential gastrointestinal side effect, though less common compared to constipation.
Jitteriness: A sign of excessive nervous system stimulation, possibly occurring due to the drug’s interference with neurotransmitter balance.
Low blood pressure: Compazine can lower blood pressure, especially in older adults, as it may affect the autonomic nervous system.
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Compazine (Prochlorperazine) Side Effect Lengths
Here is how long Compazine (prochlorperazine) side effects often last:
Side Effect | Duration | Details of Impact |
Restlessness (Akathisia) | Variable (hours to weeks) | Often resolves after dose adjustment or with the addition of an anti-parkinsonian agent. Can last days to weeks if untreated. |
Muscle Spasms (Dystonia) | Acute (hours to days) | Typically occur within hours to days after starting treatment. Symptoms usually resolve with medication adjustments or treatment with anticholinergics. |
Blurred Vision | Short-term (hours to days) | Usually occurs early in treatment. Typically resolves as the body adjusts to the medication or with dose reduction. |
Dizziness | Short-term (hours to days) | Often resolves quickly after starting treatment. May persist with long-term use, especially at higher doses. |
Xerostomia (Dry Mouth) | Short-term (hours to days) | Common during initial treatment phase; improves over time or with dose adjustments. |
Constipation | Short-term (days to weeks) | May improve with time or dietary changes, but can persist in some cases. |
Drowsiness | Short-term (hours to days) | Typically resolves as the body adjusts to the drug, though it can persist during the treatment period. |
Irregular Menstrual Periods | Variable (weeks to months) | May last for weeks to months but tends to resolve once the body adapts to the medication or the medication is adjusted. |
Psychomotor Agitation | Variable (days to weeks) | Often resolves within a few days to weeks, but may require dose adjustment or additional medications. |
Little or No Urination | Variable (days to weeks) | Usually resolves as the body adapts, but can be managed with hydration and dose adjustments. |
Nasal Congestion | Short-term (days) | Typically resolves shortly after starting the medication, often improving with time or antihistamine use. |
Dysphagia (Difficulty Swallowing) | Short-term (hours to days) | Common during early treatment; usually resolves with dose reduction or treatment adjustment. |
Impotence | Variable (weeks to months) | Can last as long as the medication is used, but may improve with dose adjustment or after discontinuation. |
Nausea | Short-term (hours to days) | Usually occurs early in treatment and tends to resolve as the body adapts to the medication. |
Drooling | Short-term (days to weeks) | Typically occurs early in treatment, especially in children or elderly, and resolves after dose adjustments or with medication changes. |
Fever | Short-term (hours to days) | Rare, but typically resolves as the body adjusts or with discontinuation of the medication. |
Headache | Short-term (hours to days) | Usually resolves within a few days of starting treatment. May persist if the dose is too high. |
Hives | Short-term (hours to days) | Typically resolves with antihistamines or discontinuation of medication if allergic reaction occurs. |
Loss of Appetite | Short-term (days to weeks) | Usually improves with time, but may persist if side effects are more severe. |
Uncontrolled Muscle Movements | Variable (days to weeks) | Often resolves with dose reduction or addition of anticholinergic agents. Can persist if untreated. |
Melena (Dark Stools) | Short-term (days) | If caused by gastrointestinal bleeding, it requires immediate medical attention and should resolve with treatment. |
Chest Pain | Short-term (hours to days) | Typically resolves after dose adjustment or with medical intervention if caused by cardiac issues. |
Dark Urine | Short-term (days to weeks) | Can be a sign of liver issues and should be monitored. Resolves itself with medical intervention if necessary. |
Diarrhea | Short-term (hours to days) | Usually resolves within a few days, but may persist with long-term use or high doses. |
Jitteriness | Short-term (hours to days) | Common at higher doses, typically resolves within days of adjusting the dose. |
Low Blood Pressure | Short-term (hours to days) | Typically resolves within a few days of adjusting the medication or dose. |
Common Questions
Questions and answers about Compazine (prochlorperazine) side effects:
Does Compazine cause restlessness?
Yes, Compazine (prochlorperazine) can cause restlessness. This is often due to extrapyramidal symptoms (EPS), which include akathisia—a feeling of inner restlessness. It is a known side effect of antipsychotic medications like Compazine, especially during the early stages of treatment or with higher doses.
In some cases, it can be severe and lead to the patient being unable to sit still. A study published in 1999 identified that psychomotor agitation, which includes restlessness, occurs in a significant percentage of patients treated with prochlorperazine (5-10%).
Does Compazine cause muscle spasms?
Yes, Compazine (prochlorperazine) can cause muscle spasms as part of its extrapyramidal symptoms (EPS). These include dystonia, which is a type of involuntary muscle contraction that can cause muscle spasms, stiffness, and abnormal posturing. These symptoms can occur shortly after initiating treatment, particularly in younger patients or those on higher doses.
The study mentioned that uncontrolled muscle movements are a side effect in a minority of patients, although the percentage is low (<5%).
Does Compazine affect men and women differently?
There is limited evidence suggesting that Compazine (prochlorperazine) affects men and women differently in terms of side effects. However, some studies show that women may be more susceptible to certain adverse effects, such as extrapyramidal symptoms (EPS), including muscle spasms and restlessness.
This has been observed in antipsychotic medications as a class, but specific data on prochlorperazine (Compazine) is less clear. The study did not report significant gender differences, but some other studies suggest that hormonal factors may influence the severity of side effects, particularly in women.
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Sources
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Ernst, A. A., Weiss, S. J., Park, S., Takakuwa, K. M., & Diercks, D. B. (2000). Prochlorperazine versus promethazine for uncomplicated nausea and vomiting in the emergency department: A randomized, double-blind clinical trial. Annals of Emergency Medicine, 36(6), 537-543. https://doi.org/10.1067/mem.2000.108652
U.S. Food and Drug Administration. (2005). Compazine (prochlorperazine) label. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/010571s096lbl.pdf
National Center for Biotechnology Information. (2019). Neuroleptic Malignant Syndrome. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK534115/
Cleveland Clinic. (n.d.). Neuroleptic Malignant Syndrome. Retrieved from https://my.clevelandclinic.org/health/diseases/22703-neuroleptic-malignant-syndrome