Compazine (Prochlorperazine) Oral Dosing
For severe nausea and vomiting in adults, the standard oral dose of prochlorperazine is 5-10 mg three to four times daily, with a maximum daily dose of 40 mg in resistant cases. 1
Standard Adult Dosing for Nausea and Vomiting
- The FDA-approved oral dosing is one 5 mg or 10 mg tablet 3-4 times daily, starting with the lowest effective dose and titrating based on response 1
- Daily dosages above 40 mg should be reserved only for resistant cases that fail to respond to standard dosing 1
- For low-emetic-risk conditions such as dizziness, the Journal of Clinical Oncology recommends 5-10 mg oral doses as rescue therapy, with titration up to a maximum of 3-4 administrations daily 2
- In clinical practice for short-term management of dizziness, prochlorperazine is typically prescribed as 10 mg orally every 6 hours as needed, according to the Mayo Clinic Proceedings 2
Dosing Adjustments for Special Populations
- Elderly patients should receive dosages in the lower range (starting with 5 mg doses), as they are more susceptible to hypotension and neuromuscular reactions 1
- Dosage should be increased more gradually in debilitated or emaciated patients, with careful monitoring and individualized titration 1
Critical Safety Considerations
- Prochlorperazine is associated with extrapyramidal symptoms (EPS) and sedation as the most common adverse effects, with EPS occurring in approximately 4-9% of patients 3
- Anticholinergic effects including hypotension and tachycardia have been reported with prochlorperazine use 2
- If dizziness or nausea persists despite prochlorperazine, consider switching to a 5-HT3 receptor antagonist like ondansetron (8 mg orally twice daily), which may have fewer extrapyramidal side effects 2
Pediatric Dosing (When Applicable)
- Prochlorperazine should not be used in pediatric patients under 20 pounds in weight or 2 years of age 1
- For children 20-29 lbs: 2.5 mg once or twice daily (maximum 7.5 mg/day) 1
- For children 30-39 lbs: 2.5 mg 2-3 times daily (maximum 10 mg/day) 1
- For children 40-85 lbs: 2.5 mg three times daily or 5 mg twice daily (maximum 15 mg/day) 1
- Children are more prone to develop extrapyramidal reactions even on moderate doses, so the lowest effective dosage should be used 1
Alternative Dosing for Psychiatric Conditions
- For non-psychotic anxiety: 5 mg 3-4 times daily, not exceeding 20 mg per day or longer than 12 weeks 1
- For psychotic disorders in outpatient settings: 5-10 mg 3-4 times daily 1
- For moderate to severe psychotic conditions: starting dose of 10 mg 3-4 times daily, with gradual increases to 100-150 mg daily in severe cases 1