From the Guidelines
Compazine (prochlorperazine) is not generally considered nephrotoxic. This medication, which belongs to the phenothiazine class of antipsychotics, is primarily used to treat nausea, vomiting, and psychotic disorders, and does not typically cause direct kidney damage or impairment. Unlike certain medications such as NSAIDs, aminoglycosides, or contrast agents that have well-established nephrotoxic effects, prochlorperazine does not have a significant risk profile for kidney injury, as noted in recent studies 1. However, it's essential to consider the potential for hypotension in some patients, which could potentially reduce kidney perfusion if severe. Additionally, the medication is primarily metabolized by the liver rather than excreted by the kidneys, further reducing its potential impact on renal function.
Some studies have discussed the mechanisms of drug-induced kidney injury or dysfunction, classifying them into systemic or renal/glomerular hemodynamic effects and tubular or structural damage 1. However, prochlorperazine is not mentioned as a nephrotoxic agent in these studies. Other medications, such as those used in cancer treatment, have been associated with nephrotoxicity, including platinum-containing compounds, ifosfamide, and gemcitabine 1. In contrast, prochlorperazine is not typically associated with these effects.
While dose adjustments are generally not required for patients with kidney disease, as with any medication, monitoring for unexpected side effects is always prudent, especially in patients with pre-existing renal impairment or those taking multiple medications. The provided evidence does not suggest that prochlorperazine is nephrotoxic, and its use is not typically associated with kidney damage or impairment 1.
Key points to consider:
- Prochlorperazine is not generally considered nephrotoxic
- The medication is primarily metabolized by the liver, reducing its potential impact on renal function
- Hypotension is a potential side effect that could reduce kidney perfusion if severe
- Monitoring for unexpected side effects is essential, especially in patients with pre-existing renal impairment or those taking multiple medications
- Recent studies do not associate prochlorperazine with nephrotoxic effects 1.
From the Research
Nephrotoxicity of Compazine (Prochlorperazine)
- The nephrotoxicity of various drugs, including their pathophysiological mechanisms and clinical management, has been studied extensively 2, 3.
- However, the specific nephrotoxicity of Compazine (prochlorperazine) is not directly addressed in most of the available studies.
- One study from 1982 investigated the effects of prochlorperazine on experimental nephrotoxicity and found that it produced a dose-related reduction in the concentrations of plasma urea nitrogen in mice that received nephrotoxic doses of methyl-CCNU 4.
- Additionally, prochlorperazine inhibited HgCl2-induced urinary excretion of N-acetylglucosaminidase and leucine aminopeptidase, and reduced the severity of HgCl2-induced renal lesions evaluated histopathologically in rats 4.
- These findings suggest that prochlorperazine may have a protective effect against acute nephrotoxicity in rodents, rather than being nephrotoxic itself.
- Other studies have focused on the nephrotoxicity of different drugs, such as cisplatin 5 and amphotericin B 6, but do not provide information on the nephrotoxicity of Compazine (prochlorperazine).