Prochlorperazine Dosage

Medically reviewed by Drugs.com. Last updated on Apr 14, 2025.

Applies to the following strengths: 5 mg/mL; 10 mg; 15 mg; 2.5 mg; 5 mg; 25 mg; 5 mg/5 mL; edisylate; maleate

Usual Adult Dose for Nausea/Vomiting

Severe Nausea and Vomiting:
Oral:

Usual dose: 5 to 10 mg orally 3 to 4 times a day
Maximum dose: 40 mg/day

Parenteral:
IM:

Usual dosage: 5 to 10 mg IM, repeated every 3 to 4 hours as necessary
Maximum dose: 40 mg/day

IV:

Usual dose: 2.5 to 10 mg slow IV injection or infusion at a rate not exceeding 5 mg/min
Maximum dose: 10 mg (single dose); 40 mg/day

Rectal:

Usual dose: 25 mg rectally 2 times a day

Adult Surgery (Severe Nausea and Vomiting):
Parenteral:
IM:

Usual dose: 5 to 10 mg IM 1 to 2 hours before anesthesia OR to control acute symptoms during/after surgery, repeated once (in 30 minutes) if necessary
Maximum dose: 40 mg/day

IV:

Usual dose: 5 to 10 mg slow IV injection or infusion (at a rate not exceeding 5 mg/min) 15 to 30 minutes before anesthesia OR to control acute symptoms during/after surgery, repeated once if necessary
Maximum dose: 10 mg (single dose); 40 mg/day

Comments:

Begin with the lowest recommended dose and adjust based on individual response.
Resistant cases may require oral doses exceeding 40 mg/day.
Patients receiving parenteral formulations may be more likely to experience hypotension.
This drug may be given as an undiluted or diluted IV solution; however, avoid bolus IV injections.

Use: For the control of severe nausea and vomiting

Usual Adult Dose for Anxiety

Oral:

Usual dose: 5 mg orally 3 to 4 times a day
Maximum dose: 20 mg/day
Duration of therapy: Up to 12 weeks

Comments:

Therapy with this drug is not a first-line treatment for most patients with non-psychotic anxiety due to the risk of adverse effects.

Use: For the short-term treatment of generalized non-psychotic anxiety

Usual Adult Dose for Psychosis

Mild psychotic disorders:

Usual dose: 5 to 10 mg orally 3 to 4 times a day

Moderate to severe psychotic disorders:
Oral:

Initial dose: 10 mg orally 3 to 4 times a day, increasing the dose in small increments every 2 to 3 days until symptoms are controlled or side effects become bothersome
Maintenance dose: 50 to 75 mg/day for some patients; 100 to 150 mg/day for patients with more severe disturbances

Parenteral:
IM:

Initial dose: 10 to 20 mg IM, repeated every 2 to 4 hours (or every hour in resistant cases), if necessary
Prolonged therapy: 10 to 20 mg IM every 4 to 6 hours

Comments:

Many patients respond after the first injection; more than 3 to 4 IM doses are seldom required.
Once patients are controlled on parenteral formulations, oral formulations should be used at the same dose or higher. Prolonged IM therapy should be used in rare cases.

Use: For the treatment of schizophrenia

Usual Adult Dose for Schizophrenia

Mild psychotic disorders:

Usual dose: 5 to 10 mg orally 3 to 4 times a day

Moderate to severe psychotic disorders:
Oral:

Initial dose: 10 mg orally 3 to 4 times a day, increasing the dose in small increments every 2 to 3 days until symptoms are controlled or side effects become bothersome
Maintenance dose: 50 to 75 mg/day for some patients; 100 to 150 mg/day for patients with more severe disturbances

Parenteral:
IM:

Initial dose: 10 to 20 mg IM, repeated every 2 to 4 hours (or every hour in resistant cases), if necessary
Prolonged therapy: 10 to 20 mg IM every 4 to 6 hours

Comments:

Many patients respond after the first injection; more than 3 to 4 IM doses are seldom required.
Once patients are controlled on parenteral formulations, oral formulations should be used at the same dose or higher. Prolonged IM therapy should be used in rare cases.

Use: For the treatment of schizophrenia

Usual Pediatric Dose for Nausea/Vomiting

Less than 2 years or less than 9 kg: Use is contraindicated

2 years and older:
Oral:
9 to 13 kg: 2.5 mg orally 1 to 2 times a day; maximum dose is 7.5 mg/day
13 to 18 kg: 2.5 mg orally 2 to 3 times a day; maximum dose is 10 mg/day
18 to 39 kg: 2.5 mg orally 3 times a day -OR- 5 mg orally 2 times a day; maximum dose is 15 mg/day

Parenteral:

Usual dose: 0.132 mg/kg IM once

Comments:

Patients should receive the lowest effective dose. Even at moderate doses, pediatric patients may be more prone to extrapyramidal reactions.
Parenteral treatment after the first dose is usually not necessary.
Avoid administering this drug to children with acute illnesses or dehydration.

Use: For the control of severe nausea and vomiting

Usual Pediatric Dose for Schizophrenia

Less than 2 years or less than 9 kg: Use is contraindicated

2 to 12 years:
Oral:

Initial dose: 2.5 mg orally 2 to 3 times a day; maximum 10 mg/day on first day
Maintenance dose: Adjust based on individual patient response
Maximum dose: 20 mg/day (2 to 5 years); 25 mg/day (6 to 12 years)

Parenteral:

Usual dose: 0.132 mg/kg IM once

Comments:

Patients should receive the lowest effective dose. Even at moderate doses, pediatric patients may be more prone to extrapyramidal reactions.
Avoid administering this drug to children with acute illnesses or dehydration.
When symptoms are controlled with the IM formulation, patients should be switched to oral formulations at the same dose or higher.

Use: For the treatment of schizophrenia

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Liver dysfunction: Data not available

Abnormal liver function tests with flu-like symptoms and fever: Treatment should be discontinued.

Dose Adjustments

Debilitated, emaciated, and/or elderly patients: Most patients respond to doses in the lower end of the dosing range. If required, dose titration should be performed gradually and patients should be closely monitored for side effects.

Depressed WBC counts with differential: Treatment should be discontinued and appropriate antibiotic therapy should be started.

Extrapyramidal reactions:

Adults: Reduce dose or discontinue treatment based on severity. If treatment is restarted, resume at a lower dosage.
Pediatric patients: Discontinue therapy and do not reinstitute.

Neuroleptic malignant syndrome: Immediately discontinue therapy.

Tardive dyskinesia: Consider treatment discontinuation.

Precautions

US BOXED WARNING:

INCREASED MORTALITY IN OLDER ADULT PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS: Older patients with dementia-related psychosis treated with antipsychotic drugs have an increased risk of death. The majority of deaths were either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. This drug is not approved for use in patients with dementia-related psychosis.

CONTRAINDICATIONS:

Hypersensitivity to the active component or any of the ingredients (except some suppository formulations)
Comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.)
Children under 2 years old, less than 9 kg, or with conditions where safety has not been established
Pediatric surgery

Safety and efficacy have not been established in patients younger than 2 years or less than 9 kg.

Consult WARNINGS section for additional precautions.

Dialysis

Limited experience indicates that phenothiazines are not dialyzable.

Other Comments

Administration advice:

IM injections should be administered deeply into the upper, outer quadrant of the buttock. Inspect solution before administration; discard if discolored.
IV injections may be administered undiluted, or diluted in isotonic solution; do not give as IV bolus.
Subcutaneous administration is not advisable because of local irritation.
Suppositories: Do not remove from wrapper until ready to use.
Do not administer further doses in pediatric patients that exhibit restlessness or excitement after dosing.

Storage requirements:

Refer to the manufacturer product information for the specific formulation being used.

Reconstitution/preparation techniques:

Refer to the manufacturer product information for the specific formulation being used.

IV compatibility:

Do not mix parenteral prochlorperazine with any other agents in the same syringe.
See the manufacturer product information for additional recommendations.

General:

This drug should not be used in pediatric surgery.
Symptom control is usually achieved after the first dose of a parenteral formulation.
Effectiveness for non-psychotic anxiety was established in a 4-week trial and included patients with generalized anxiety disorder. It is unknown whether patients with other conditions (e.g., physical illness, organic mental conditions, agitated depression, character pathologies) will experience the same benefits.
This drug is not usually a first-line agent for the treatment of non-psychotic anxiety due to the risk of severe side effects not observed in other treatment options.
Treatment has not been shown effective in the management of behavioral complications associated with mental disabilities.
This drug should not be used in children with signs/symptoms of Reye's syndrome.

Monitoring:

Cardiovascular: Blood pressure, especially in patients with impaired cardiovascular systems and pediatric patients, especially after parental administration
Hematologic: WBC with differential tests, especially in patients with signs/symptoms of infection/sore throat, at increased risk of blood dyscrasias, and/or with a history of low WBCs or drug-induced neutropenia/leukopenia (as indicated during treatment)
Hepatic: Liver function tests in patients with flu-like symptoms (as indicated during treatment)
Other: Body temperature, especially in patients at risk of hyper- or hypothermia (during treatment)
Psychiatric: Excitement and/or restlessness in pediatric patients (after dose administration)

Patient advice:

Patients should be warned to avoid abrupt discontinuation of this drug.
Patients should be instructed to immediately report any signs/symptoms of neutropenia/leukopenia, liver toxicity, neuroleptic malignant syndrome, or tardive dyskinesia.
Inform patients that this drug may cause or impair mental/physical abilities, and they should avoid driving or operating machinery until the full effects of the drug are seen.
Patients should be advised to speak to a healthcare provider if they are pregnant, intend to become pregnant, or are breastfeeding.
Parents of pediatric patients should be told to avoid exceeding the prescribed dosage, and should be instructed to report any signs/symptoms of restlessness and/or excitement.