CHLORPROMAZINE oral

Prescription under medical supervision

Therapeutic action

– Sedative antipsychotic 

Indications

– Acute or chronic psychosis

Forms and strengths

– 25 mg and 100 mg tablets

Dosage

– Adult: 25 to 75 mg once daily in the evening. Increase gradually up to 100 mg 3 times daily if necessary.
– Reduce the dose by half in elderly patients.
– Use the lowest effective dose, especially in the event of prolonged treatment.

Duration

 Acute psychosis: minimum 3 months; chronic psychosis: minimum one year. The treatment should be discontinued gradually (over 4 weeks). If signs of relapse occur, increase the dose.

Contra-indications, adverse effects, precautions

– Do not administer to patients with cardiac disorders (heart failure, recent myocardial infarction, conduction disorders,  bradycardia, etc.), dementia (e.g. Alzheimer's disease), closed-angle glaucoma, prostate disorders, Parkinson's disease and history of neuroleptic malignant syndrome.
– Administer with caution and carefully monitor use in elderly patients and patients with hypokalaemia, hypotension, renal or hepatic impairment, history of seizures. 
– May cause:
• drowsiness, dyskinesia, extrapyramidal symptoms, weight gain, orthostatic hypotension, hyperprolactinaemia, anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation, tachycardia);
• hyperglycaemia, photosensitivity, impaired thermoregulation; agranulocytosis, neuroleptic malignant syndrome (unexplained hyperthermia with neuromuscular disorders), rare but requiring immediate treatment discontinuation.  
– In the event of extrapyramidal symptoms, combine with biperiden or trihexyphenidyl.
– Avoid or monitor combination with: 
• central nervous system depressants (opioid analgesics, sedatives, H1 antihistamines, etc.); drugs with anticholinergic effects (amitriptyline, atropine, clomipramine, promethazine, etc.), antidiabetics, lithium;
• antihypertensive drugs (risk of hypotension); drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.). 
– Avoid alcohol during treatment.
– Pregnancy: re-evaluate whether the treatment is still necessary; if it is continued, monitor the neonate for extrapyramidal and/or anticholinergic effects (tremor, abdominal distension, hyperexcitability, etc.) if the mother was treated in the 3rd trimester.
– Breast-feeding: avoid

Remarks

– Do not crush tablets (risk of contact dermatitis).
– Storage: below 25 °C -  -