From the FDA Drug Label
IV Dosage 2.5 mg to 10 mg (0. 5 to 2 mL) by slow IV injection or infusion at a rate not to exceed 5 mg per minute. ... A single dose of the drug should not exceed 10 mg; total IV dosage should not exceed 40 mg per day.
The recommended dosing frequency for intravenous Compazine (prochlorperazine) 10 mg in pregnancy is not explicitly stated in the drug label. However, the label states that the total IV dosage should not exceed 40 mg per day, and a single dose should not exceed 10 mg.
- The label does mention that for severe nausea and vomiting, IV dosage can be repeated, but it does not specify the exact frequency for pregnant patients.
- The drug label advises to adjust dosage to the response of the individual and to monitor carefully.
- For adult surgery, the label recommends a dose of 5 mg to 10 mg, 15 to 30 minutes before induction of anesthesia, which can be repeated once if necessary 1. However, the label does not provide specific guidance on dosing frequency for pregnant patients.
From the Research
Intravenous Compazine (prochlorperazine) 10 mg should be administered every 3-4 hours as needed for nausea and vomiting during pregnancy, with a maximum daily dose of 40 mg, as recommended by the most recent and highest quality study available 2. The dosing frequency of intravenous Compazine (prochlorperazine) 10 mg in pregnancy is crucial to balance adequate symptom control with minimizing potential risks.
- The medication should be used cautiously during pregnancy and only when the potential benefits outweigh the risks, as it is classified as FDA pregnancy category C.
- While prochlorperazine has been used for hyperemesis gravidarum and severe nausea in pregnancy, it should generally be considered a second-line agent after safer alternatives have failed.
- Side effects to monitor include sedation, hypotension (especially with IV administration), and extrapyramidal symptoms.
- Administration should occur slowly over at least 5 minutes when given IV to reduce the risk of hypotension.
- Treatment duration should be limited to the shortest period necessary for symptom control, and the patient should be transitioned to oral therapy when possible. The most recent guideline from the American College of Obstetricians and Gynecologists (ACOG) 2 emphasizes the importance of early treatment of nausea and vomiting in pregnancy to prevent more serious complications, including hospitalization.
- The guideline recommends that treatment should be individualized based on the severity of symptoms and the patient's response to therapy.
- It also highlights the need for careful monitoring of side effects and adjustment of the treatment regimen as needed. Overall, the recommended dosing frequency of intravenous Compazine (prochlorperazine) 10 mg in pregnancy is every 3-4 hours as needed, with a maximum daily dose of 40 mg, and should be used cautiously and with careful monitoring of side effects 2, 3.