Chlorpromazine is prescribed for pain relief and to treat the symptoms of certain types of mental illness, such as the emotional symptoms of psychosis and the manic phase of manic-depressive illness (sometimes called bipolar disorder). Chlorpromazine is thought to relieve the symptoms of mental illness by blocking certain chemicals involved with nerve transmission in the brain.

Chlorpromazine may also be used to treat tetanus, porphyria, uncontrollable hiccups, anxiety before surgery, and nausea and vomiting.

Chlorpromazine Facts
Brand names (manufacturers):
chlorpromazine hydrochloride (GlaxoSmithKline); Thorazine (GlaxoSmithKline); Thorazine Spansules (GlaxoSmithKline)

Type of drug: Phenothiazine tranquilizer

Ingredient: Chlorpromazine hydrochloride

Dosage forms: Tablets (10 mg, 25 mg, 50 mg, 100 mg, and 200 mg); sustained-release capsules (30 mg, 75 mg, and 150 mg); oral concentrate (30 mg per mL and 100 mg per mL); oral syrup (10 mg per 5-mL spoonful); suppositories (25 mg and 100 mg)

Storage: Store the tablet and capsule forms of this medication at room temperature in tightly closed, light-resistant containers. Keep the syrup and suppository forms in the refrigerator in tightly closed, light-resistant containers. If the concentrate or syrup turns to a slight yellow color, the medicine is still effective and can be used. However, if the concentrate or syrup changes color markedly or has particles floating in it, it should not be used; instead, it should be discarded down the sink. Chlorpromazine should never be frozen.

Treatment

To avoid stomach irritation, take the tablets or capsules with a meal or with a glass of water or milk (unless your doctor directs you to do otherwise). The sustained-release capsules should be taken whole; do not crush, break, or open them prior to swallowing. Breaking the capsule would release the medication all at once, defeating the purpose of the extended-release capsules.

Be sure to measure the syrup form of chlorpromazine carefully with a specially designed 5-mL measuring spoon. An ordinary kitchen teaspoon is not accurate enough for medicinal purposes.

Measure the concentrate carefully with the dropper provided, then add it to four ounces (one-half cup) or more of water, milk, a carbonated beverage, applesauce, or pudding just before taking it.

Be careful that the serving size is not more than the patient is willing or able to drink or eat; otherwise, the full dose may not be consumed. To prevent possible loss of effectiveness, chlorpromazine should not be diluted in tea, coffee, or apple juice.

To use the suppository, remove the foil wrapper and moisten the suppository with water (if the suppository is too soft to insert, refrigerate it for half an hour or run cold water over it before removing the wrapper). Lie on your left side with your right knee bent. Push the suppository into the rectum, pointed end first. Lie still for a few minutes. Try to avoid having a bowel movement for at least an hour.

If you miss a dose of chlorpromazine, take the missed dose as soon as possible, then return to your regular schedule. However, if it is almost time for the next dose, skip the one you missed and return to your regular schedule. Do not double the dose of this medication (unless your doctor directs you to do so).

Antacids and antidiarrheal medicines may decrease the absorption of this medication from the gastrointestinal tract. Therefore, at least one hour should separate doses of any of these medicines and chlorpromazine.

The full effects of chlorpromazine for the control of emotional or mental symptoms may not become apparent for two weeks after you start to take it.

Side Effects

Minor: Blurred vision, constipation, decreased sweating, diarrhea, dizziness, drooling, drowsiness, dry mouth, fatigue, jitteriness, menstrual irregularities, nasal congestion, restlessness, tremors, vomiting, or weight gain. As your body adjusts to the medication, these side effects should disappear.

Chlorpromazine can cause increased sensitivity to sunlight. It is, therefore, important to avoid prolonged exposure to sunlight or sunlamps. Wear protective clothing and use an effective sunscreen.

Chlorpromazine can also cause discoloration of the urine to red, pink, or red-brown. This is a harmless effect.

If you experience constipation as a side effect of this medication, increase the amount of fiber in your diet (eat more fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise).

Chew sugarless gum or suck on ice chips or a piece of hard candy to help reduce mouth dryness.

To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion.

Major: Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about breast enlargement (in both sexes); chest pain; convulsions; darkened skin; difficulty in swallowing or breathing; fainting; fever; impotence; involuntary movements of the face, mouth, jaw, or tongue; palpitations; rash; sleep disorders; sore throat; uncoordinated movements; unusual bleeding or bruising; visual disturbances; or yellowing of the eyes or skin.

Interactions

Chlorpromazine will interact with several other types of medications:
  • Chlorpromazine can cause extreme drowsiness when combined with alcohol or other central nervous system depressants (such as barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, and pain medications) or with tricyclic antidepressants, fluoxetine, fluvoxamine, paroxetine, or maprotiline.

  • Chlorpromazine can decrease the effectiveness of amphetamines, guanethidine, anticonvulsants, levodopa, and oral anticoagulants.

  • The side effects of cyclophosphamide, epinephrine, monoamine oxidase (MAO) inhibitors, phenytoin, and tricyclic antidepressant medications may be increased by concurrent use of chlorpromazine.

  • Chlorpromazine can increase the absorption of propranolol, which can increase the risk of side effects.

  • Lithium may increase the side effects and may decrease the effectiveness of chlorpromazine.

  • The side effects of disopyramide, erythromycin, pimozide, probucol, procainamide, and quinidine may be increased with chlorpromazine.

  • Before starting to take chlorpromazine, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above.

Warnings
  • Tell your doctor about unusual or allergic reactions you have had to any medications, especially to chlorpromazine or any other phenothiazine tranquilizers (such as fluphenazine, mesoridazine, perphenazine, prochlorperazine, promazine, thioridazine, and trifluoperazine) or to the drug loxapine.

  • Tell your doctor if you are allergic to dyes, especially to FD&C Yellow No. 5 (tartrazine).

  • Tell your doctor if you have a history of alcoholism or if you now have or ever had blood disease, bone marrow disease, brain disease, breast cancer, blockage in the urinary or digestive tract, drug-induced depression, epilepsy, high or low blood pressure, diabetes mellitus, glaucoma, heart or circulatory disease, liver disease, lung disease, Parkinson's disease, peptic ulcers, or an enlarged prostate gland.

  • Tell your doctor about any recent exposure to a pesticide or an insecticide. Chlorpromazine may increase the side effects from the exposure.

  • To prevent oversedation, avoid drinking alcoholic beverages while you are taking chlorpromazine.

  • If chlorpromazine makes you dizzy or drowsy, avoid any activity that requires alertness, such as driving a car or operating potentially dangerous equipment.

  • Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking chlorpromazine.

  • Some of the side effects caused by this drug can be prevented by taking a drug for Parkinson's disease. Discuss this with your doctor.

  • This medication can decrease sweating and heat release from the body. You should, therefore, avoid becoming overheated by strenuous exercise in hot weather and should avoid taking hot baths, showers, and saunas.

  • Do not stop taking chlorpromazine suddenly. If the drug is stopped abruptly, you may experience nausea, vomiting, stomach upset, headache, increased heart rate, insomnia, tremors, or a worsening of your condition. Your doctor may want to reduce the dosage of chlorpromazine gradually before stopping it completely.

  • If you are planning to have a myelogram or any other medical procedure in which dye will be injected into your spinal cord, be sure to tell the doctor that you are taking chlorpromazine.

  • Avoid spilling the oral concentrate or oral syrup forms of this medication on your skin or clothing: It may cause redness and irritation of the skin.

  • While you are being treated with chlorpromazine, do not take any over-the-counter (nonprescription) medications for weight control or for cough, cold, allergy, asthma, or sinus problems without first checking with your doctor. The combination of these medications with chlorpromazine may cause high blood pressure.

  • Be sure to tell your doctor if you are pregnant. Small amounts of chlorpromazine cross the placenta. Although there have been reports of safe use of this drug during pregnancy, there have also been reports of liver disease and tremors in newborn infants whose mothers received this medication close to term. Also tell your doctor if you are breast-feeding an infant. Small amounts of chlorpromazine pass into breast milk and may affect the nursing infant.