Administration of Stemitil (Prochlorperazine) 12.5mg Injection Intramuscularly
Yes, Stemitil (prochlorperazine) 12.5mg injection can be administered intramuscularly without dilution. 1
Administration Guidelines
- Prochlorperazine for intramuscular (IM) use should be injected deeply into the upper, outer quadrant of the buttock 1
- The injection should NOT be administered subcutaneously as this can cause local irritation 1
- For adults, the standard IM dosage is 5-10 mg (1-2 mL) injected deeply, which can be repeated every 3-4 hours if necessary 1
- Total IM dosage should not exceed 40 mg per day 1
Clinical Considerations
Dosing Considerations
- Dosage should be increased more gradually in debilitated, emaciated, or elderly patients 1
- Elderly patients appear more susceptible to hypotension and neuromuscular reactions, requiring careful monitoring 1
- For severe nausea and vomiting, the initial dose is typically 5-10 mg (1-2 mL) IM 1
Pediatric Use
- Prochlorperazine should NOT be used in pediatric patients under 20 pounds in weight or under two years of age 1
- Children seem more prone to develop extrapyramidal reactions, even on moderate doses 1
- For children, dosage calculation is based on weight (specific pediatric dosing should be followed) 1
Safety Profile
Common Side Effects
- Pain and irritation at the injection site have been reported but are uncommon with proper technique 1
- Extrapyramidal symptoms (EPS) are the most common neurological side effects, particularly in children 2
- In a real-world study with oral prochlorperazine, adverse reactions were rare (0.006%) and mild (headache, asthenia, somnolence) 3
Precautions
- Monitor for hypotension, especially in elderly or volume-depleted patients 1
- Watch for extrapyramidal reactions, which may include dyskinesia, impaired consciousness, pyramidal signs, and hypertonus 2
- If restlessness or excitement occurs, do not administer additional doses 1
- Take particular precaution when administering to patients with acute illnesses or dehydration 1
Clinical Efficacy
- Prochlorperazine is effective for controlling nausea and vomiting from various causes 4, 5
- In studies of IV administration, the mean time to cessation of vomiting was 8.5 minutes for IV versus 35 minutes for IM administration 4
- The drug has shown effectiveness even in patients with acute myocardial infarction without causing symptomatic hypotension 5
Storage and Stability
- The solution should be protected from light 1
- Slight yellowish discoloration will not alter potency 1
- If markedly discolored, the solution should be discarded 1
Remember that proper injection technique is essential to minimize local irritation and pain. Always verify the correct dose before administration, particularly in vulnerable populations like the elderly or children.