Drugs Q & A

Why Was Compazine Discontinued?

Compazine is a brand name for the prescription drug prochlorperazine, which belongs to a class of drugs called phenothiazines. It is primarily used to treat nausea and vomiting, and is sometimes used to treat psychiatric disorders such as schizophrenia and anxiety.

The development of prochlorperazine dates back to the 1950s, when it was first synthesized by a research team at the French pharmaceutical company Rhône-Poulenc. It was subsequently introduced as a prescription medication under the brand name Compazine by SmithKline & French (now known as GlaxoSmithKline).

Compazinewas approved by the U.S. Food and Drug Administration (FDA) in 1956 for the treatment of various conditions, including:

•       Nausea and vomiting associated with surgery, radiation therapy, or cancer chemotherapy

•       Schizophrenia

•       Anxiety

•       Intractable hiccups

•       Migraine headaches

Compazine quickly became a popular medication for the treatment of nausea and vomiting associated with a variety of conditions, including migraine headaches, chemotherapy, and radiation therapy. It was also used to treat psychiatric disorders, particularly in patients who did not respond to other treatments.

Over the years, Compazine has been widely studied and its safety and effectiveness have been well-established. However, like all medications, it can cause side effects, and it is important for patients to discuss their medical history and any medications they are taking with their healthcare provider before starting treatment with Compazine.

How is Compazine used?

Compazine is available in various forms, including tablets, capsules, and injections. The dosage and method of administration will depend on the patient’s age, medical condition, and other factors, and should be determined by a healthcare provider.

When used to treat nausea and vomiting, Compazine is usually taken orally, either as a tablet or capsule, with or without food. The usual recommended dose is 5 to 10 milligrams every four to six hours as needed, not to exceed 40 mg per day. In some cases, it may be given as an injection or suppository.

When used to treat psychiatric disorders, Compazine is usually taken in higher doses than when used for nausea and vomiting. The usual recommended dose for adults is 10 to 40 milligrams per day, divided into two or more doses. However, the dosage may vary depending on the patient’s condition and response to treatment.

It is important to follow the dosage instructions provided by your healthcare provider and not exceed the recommended dose. Compazine can cause side effects, and some people may be more sensitive to it than others. If you experience any unusual symptoms or side effects, contact your healthcare provider immediately.

Why Was Compazine Discontinued?

GlaxoSmithKline has discontinued the Compazine brand in the United States for safety reasons, but generic versions of the medication and brands like Stemetil (Prochlorperazine) are still available as a prescription medication in many other countries including the United Kingdom. It remains a widely used medication for the treatment of nausea and vomiting associated with various medical conditions.

However, the U.S. Food and Drug Administration (FDA) has issued several warnings related to the use of Compazine (prochlorperazine) and other medications in the same class (phenothiazines) due to their potential to cause serious side effects.

One warning relates to the risk of QT prolongation, a heart rhythm disorder that can be life-threatening. Compazine has been associated with QT prolongation, particularly when used at higher doses or for prolonged periods. The FDA recommends that healthcare providers monitor patients for signs of QT prolongation, particularly in those with pre-existing heart conditions, and avoid using Compazine in patients with a history of QT prolongation or other risk factors.

Another warning relates to the risk of tardive dyskinesia, a movement disorder that can be irreversible, and which has been associated with prolonged use of phenothiazines like Compazine. The FDA recommends that healthcare providers monitor patients for signs of tardive dyskinesia, particularly in those who have been taking the medication for prolonged periods or at higher doses.

In addition, the FDA has issued a warning about the use of Compazine in elderly patients with dementia-related psychosis, as it has been associated with an increased risk of death in this population. Compazine is not approved for the treatment of dementia-related psychosis.

It is important for patients to discuss any concerns or questions about the use of Compazine with their healthcare provider, and to report any unusual symptoms or side effects immediately.

What are the side effects of Compazine?

Compazine (prochlorperazine) can cause side effects, some of which may be serious. The most common side effects include:

•       Drowsiness

•       Dizziness

•       Dry mouth

•       Blurred vision

•       Constipation

•       Headache

•       Insomnia

•       Restlessness

Other less common side effects may include:

•       Movement disorders, such as dystonia, akathisia, and tardive dyskinesia

•       Neuroleptic malignant syndrome, a potentially life-threatening condition that can cause fever, muscle rigidity, and other symptoms

•       Seizures

•       Blood disorders, such as agranulocytosis and leukopenia

•       Liver problems

•       Jaundice

•       Allergic reactions, including skin rash, hives, and swelling of the face, lips, tongue, or throat

•       QT prolongation, a heart rhythm disorder that can be life-threatening

It is important to note that this is not a complete list of all possible side effects of Compazine. Some people may experience different or more severe side effects, and others may not experience any side effects at all. It is important to discuss any concerns or questions about the use of Compazine with a healthcare provider. If you experience any unusual symptoms or side effects, contact your healthcare provider immediately.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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