Parenteral Manual

ChlorproMAZINE HCl

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
LARGACTIL®
Classification: 
Antipsychotic-Antiemetic, Antianxiety
Original Date: 
August 2005
Revised Date: 
November 2011
Indications: 
  • Psychosis           -  Anxiety                     - Delirium
  • Vomiting              - Pain                          - Disruptive behaviour
Reconstitution and Stability: 
  • Protect from light; slight yellow colour does not affect potency; discard if markedly discoloured or pink
  • 25 mg/mL ampoule
Compatibility: 

- Solutions Compatible:  dextrose solutions up to D10W, NS, dextrose-saline combinations, ringer's solution, ringer's lactate

- Additives/buretrol Compatible: morphine, fentanyl and meperidine for 15 minutes in the same syringe; benztropine, diphenhydramine, glycopyrrolate, hydromorphone

- Y-site Compatible: KCl (up to 40 mmoL/L), heparin, TPN (only if TPN does not contain ranitidine)

- Incompatible: ampicillin, furosemide, penicillin, phenobarbital, dimenhydrinate, ranitidine, thiopental, tazocin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES, deeply into upper outer quadrant of the buttock (preferred route); alternate sites
IV Direct

YES
Usual dilution: <1 mg/mL
Infusion rate: do not exceed 0.5 mg/min in children (1 mg/min in adults)
IV Intermittent Infusion YES
Usual dilution: <1 mg/mL
Infusion rate: do not exceed 0.5 mg/min in children (1 mg/min in adults)
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatrics: (> 6 months)

  • Psychoses, nausea and vomiting : 0.5 - 1 mg/kg/dose IM/IV Q 6-8 hours
  •  Maximum IV/IM doses:
           < 5 years :   40 mg/day
          5-12 years:  75 mg/day    

Adults:

  • Psychoses:  25 mg IV/IM initially, may repeat (25-50 mg) in 1-4 hours, gradually increase to a maximum of 400 mg/dose Q 4-6 hours (usual dose: 300-800 mg/day)
  • Nausea/Vomiting:    25-50 mg IV/IM Q 4-6 hours
Potential hazards of parenteral administration: 
  • IV route can cause hypotension;  monitor BP during IV administration
  • Keep patients supine for at least ½ hour after administration
  • Thrombophlebitis

Common Adverse Effects:

  • Sedation
  • Anticholinergic effects - dry mouth, blurred vision, urinary retention
  • Extrapyramidal effects - acute dystonias, akathesia, Parkinsonism (reversible with diphenhydramine or benztropine)

Serious Adverse Effects:

  • Neuroleptic withdrawal syndrome, neuroleptic malignant syndrome
  • Cardiac arrhythmias
  • Lowered seizure threshold
Notes: 
  • Potentiates the action of CNS depressants
  • Avoid skin contact due to possible contact dermatitis

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