From the Guidelines
Compazine (prochlorperazine) is considered compatible with use during pregnancy, including the first trimester, according to the most recent guidelines. The 2023 EASL clinical practice guidelines on the management of liver diseases in pregnancy indicate that prochlorperazine can be used in pregnancy, with the table showing it as compatible in all trimesters, as well as with breastfeeding and paternal exposure 1. This suggests that the potential benefits of using prochlorperazine for conditions like hyperemesis gravidarum may outweigh the risks, especially when used at the lowest effective dose for the shortest duration necessary.
Key points to consider when prescribing Compazine during pregnancy include:
- Monitoring for potential side effects, such as extrapyramidal symptoms or oculogyric crises, which can occur with the use of phenothiazines like prochlorperazine 1.
- Being aware of the potential for neonatal effects if the drug is used near the time of delivery, such as withdrawal symptoms or jaundice.
- Discussing the specific risks and benefits with the patient, considering individual circumstances that may affect this assessment.
It's also important to note that alternative treatments with better safety profiles during pregnancy should be considered first when possible. However, the recent guideline suggests that prochlorperazine can be a viable option when clearly needed, supporting its use in the management of conditions like hyperemesis gravidarum during pregnancy 1.
From the Research
Compazine Pregnancy Safety
- The safety of Compazine (prochlorperazine) during pregnancy is a concern, as it is a medication used to treat nausea and vomiting, which are common symptoms during pregnancy.
- According to a study published in 2003 2, prochlorperazine was compared to pyridoxine-metoclopramide combination therapy and promethazine monotherapy in the treatment of nausea and vomiting in pregnancy. The results showed that combination therapy with pyridoxine and metoclopramide was superior to prochlorperazine monotherapy.
- Another study published in 2013 3 discussed the treatment of nausea and vomiting in pregnancy, but did not specifically address the safety of prochlorperazine during pregnancy.
- There is limited information available on the safety of prochlorperazine during pregnancy, and more research is needed to fully understand its effects.
- However, it is known that benzodiazepines, a different class of medications, have been associated with an increased risk of miscarriage during pregnancy 4.
- A study published in 1994 5 discussed the effects of benzodiazepine use during pregnancy and lactation, but did not specifically address prochlorperazine.
- A study published in 2001 6 discussed the safety of doxylamine-pyridoxine (Diclectin) during pregnancy, but did not address prochlorperazine.
- In general, it is recommended that medications during pregnancy be used with caution and only under the guidance of a healthcare provider.