Is prochlorperazine available in Alberta, Canada?

Availability of Prochlorperazine in Alberta, Canada

Yes, prochlorperazine is available in Alberta, Canada, as it is listed as an antiemetic medication in multiple clinical practice guidelines used across North America, including those relevant to Canadian healthcare settings. 1

Evidence for Availability

Prochlorperazine is documented in multiple clinical practice guidelines as a standard antiemetic option:

• The American Family Physician guidelines for migraine management list prochlorperazine (Compazine) as an effective adjunctive therapy for treating headache pain and associated symptoms 1
• The American Society of Clinical Oncology antiemetics guidelines include prochlorperazine as a breakthrough treatment option for chemotherapy-induced nausea and vomiting 1
• The National Comprehensive Cancer Network (NCCN) guidelines specifically list prochlorperazine as an antiemetic option at doses of:
  • 10 mg PO or IV every 4-6 hours
  • 25 mg suppository PR every 12 hours 1

Pharmacist Prescribing in Alberta

Alberta has one of the most progressive pharmacy practice frameworks in North America:

• Since 2007, Alberta pharmacists have had prescribing authority under the Health Professions Act and Pharmacists Profession Regulations 2, 3
• A 2017 survey showed that 93.4% of Alberta pharmacists actively prescribe medications, with the most common practices being prescription renewals (92.3%) and dose alterations (74.3%) 4
• Pharmacists in Alberta can adapt prescriptions to meet patient needs or extend therapy when patients cannot contact their original prescriber 3

Clinical Uses of Prochlorperazine

Prochlorperazine is commonly used for:

1. Antiemetic therapy:

   • For breakthrough nausea/vomiting during chemotherapy at doses of 10 mg PO/IV every 4-6 hours or 25 mg suppository every 12 hours 1
   • As an option for low emetic risk chemotherapy regimens 1

2. Migraine management:

   • As an adjunctive therapy that can effectively relieve headache pain 1

Important Considerations

Dosing

• Typical oral/IV dosing: 5-10 mg every 6-8 hours, maximum 40 mg daily 1
• Suppository form: 25 mg every 12 hours 1

Adverse Effects

• Monitor for extrapyramidal symptoms and dystonic reactions 1
• Long-term use carries risk of tardive dyskinesia 5
• Other potential side effects include CNS depression, anticholinergic effects, and rare cases of drug-induced leukopenia or neutropenia 1

Precautions

• Use with caution in patients with history of leukopenia, dementia, glaucoma, or seizure disorder 1
• Consider diphenhydramine 25-50 mg PO or IV every 4-6 hours for management of dystonic reactions 1

Alternative Antiemetics Available in Alberta

If prochlorperazine is not suitable or available for a specific patient, alternatives include:

• Ondansetron: 8 mg PO twice daily or 8 mg IV 6
• Metoclopramide: 10-40 mg PO or IV every 4-6 hours 1
• Promethazine: 12.5-25 mg PO or IV every 4 hours 1

Prochlorperazine remains a valuable and accessible antiemetic option for patients in Alberta, Canada, with established prescribing pathways through both physicians and pharmacists.