Parenteral Manual

Methotrimeprazine

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): 
NOZINAN®
Classification: 
Antipsychotic, antianxiety, sedative
Original Date: 
August 2005
Revised Date: 
January 2010
Indications: 
  • Psychosis, delirium, disruptive behaviour, anxiety
  • Vomiting
  • Pain
Reconstitution and Stability: 
  • Available as a 25 mg/mL injection. Store at room temperature   
  • Protect from light - discard markedly discoloured solutions 
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl

- Additives/Above Cassette Compatible: perphenazine, hydroxyzine (for 15 minutes); atropine, scopolamine

-Y-site Compatible: no information

-Incompatible: heparin, ranitidine 

Administration: 

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

SC NO, not recommended due to local irritation
IM

YES, deep into large muscle; rotate injection sites
Usual dilution: undiluted
IV Direct NO
IV Intermittent Infusion

YES, blood pressure monitoring
Usual dilution: 0.2 mg/mL
Infusion time: 20-30 minutes
IV Continuous Infusion NO
Dosage: 

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

Pediatric:

  • Palliative Care: starting doses 0.2 mg/kg IV Q4H PRN  Max 10 mg/dose
  • Maximum dose 0.4 mg/kg/dose  Max 10 mg/dose
Potential hazards of parenteral administration: 
  • Decreased BP presenting as dizziness, fainting, syncope or weakness.  Usually occurs within 10-20 minutes following IM injections and can last up to 12 hours
  • Orthostatic hypotension
  • Pain at injection site, dermatitis
  • Tachycardia or bradycardia, arrhythmias
  • Extrapyramidal effects, grand mal seizures
  • Disorientation, excessive sedation, slurring of speech
  • Nausea, vomiting, abdominal discomfort
Notes: 
  • Contraindicated in patients with severe cardiac, hepatic or renal disease, in the presence of overdose of CNS depressants or comatose states
  • May potentiate the action of other CNS depressants (barbiturates, analgesics, narcotics, antihistamines); dose reductions are suggested during concomitant use.
  • Because orthostatic hypotension may be encountered at the start of treatment, keep patient supine for 6-12 hours after initial dose

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