Thorazine (Chlorpromazine Hydrochloride)

(klor proe' ma zeen)

Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as chlorpromazine have an increased chance of death during treatment.

Chlorpromazine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) and other psychotic disorders (conditions that cause difficulty telling the difference between things or ideas that are real and things or ideas that are not real) and to treat the symptoms of mania (frenzied, abnormally excited mood) in people who have bipolar disorder (manic depressive disorder; a condition that causes episodes of mania, episodes of depression, and other abnormal moods). Chlorpromazine is also used to treat severe behavior problems such as explosive, aggressive behavior and hyperactivity in children 1 to 12 years of age. Chlorpromazine is also used to control nausea and vomiting, to relieve hiccups that have lasted one month or longer, and to relieve restlessness and nervousness that may occur just before surgery. Chlorpromazine is also used to treat acute intermittent porphyria (condition in which certain natural substances build up in the body and cause stomach pain, changes in thinking and behavior, and other symptoms). Chlorpromazine is also used along with other medications to treat tetanus (a serious infection that may cause tightening of the muscles, especially the jaw muscle). Chlorpromazine is in a class of medications called conventional antipsychotics. It works by changing the activity of certain natural substances in the brain and other parts of the body.

Chlorpromazine comes as a tablet to take by mouth. Chlorpromazine is usually taken two to four times a day. When chlorpromazine is used to control nausea and vomiting, it is usually taken every 4-6 hours as needed. When chlorpromazine is used to relieve nervousness before surgery, it is usually taken 2-3 hours before surgery. When chlorpromazine is used to relieve hiccups, it is usually taken 3-4 times a day for up to 3 days or until the hiccups stop. If the hiccups do not stop after 3 days of treatment, a different medication should be used. If you are taking chlorpromazine on a regular schedule, take it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take chlorpromazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of chlorpromazine and gradually increase your dose. Your doctor may decrease your dose once your condition is controlled. Be sure to tell your doctor how you are feeling during your treatment with chlorpromazine. If you are taking chlorpromazine to treat schizophrenia or another psychotic disorder, chlorpromazine may control your symptoms but will not cure your condition. Continue to take chlorpromazine even if you feel well. Do not stop taking chlorpromazine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking chlorpromazine, you may experience withdrawal symptoms, such as nausea, vomiting, stomach pain, dizziness, and shakiness.

Before taking chlorpromazine,
• tell your doctor and pharmacist if you are allergic to chlorpromazine; other phenothiazines such as fluphenazine, perphenazine, prochlorperazine (Compazine), promethazine (Phenergan), thioridazine, and trifluoperazine; or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin); antidepressants; antihistamines; atropine (in Motofen, in Lomotil, in Lonox); barbiturates such as pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal); cancer chemotherapy; diuretics (water pills); epinephrine (Epipen); guanethidine (not available in the US); ipratropium (Atrovent); lithium (Eskalith, Lithobid); medications for anxiety, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, ulcers, or urinary problems; medications for seizures such as phenytoin (Dilantin); narcotic medications for pain; propranolol (Inderal); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had asthma; emphysema (a lung disease that causes shortness of breath); an infection in your lungs or bronchial tubes (tubes that bring air to the lungs); trouble keeping your balance; glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision); breast cancer; pheochromocytoma (tumor on a small gland near the kidneys); seizures; an abnormal electroencephalogram (EEG; test that records electrical activity in the brain); any condition that affects the production of blood cells by your bone marrow; or heart, liver, or kidney disease. Also tell your doctor if you have ever had to stop taking a medication for mental illness due to severe side effects or if you plan to work with organophosphorus insecticides (a type of chemical used to kill insects).
• if you will be using chlorpromazine to treat nausea and vomiting, it is important to tell your doctor about any other symptoms you are experiencing, especially listlessness; drowsiness; confusion; aggression; seizures; headaches; problems with vision, hearing, speech, or balance; stomach pain or cramps; or constipation. Nausea and vomiting that is experienced along with these symptoms may be a sign of a more serious condition that should not be treated with chlorpromazine.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking chlorpromazine, call your doctor. Chlorpromazine may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking chlorpromazine.
• if you are having a myelogram (x-ray examination of the spine), tell your doctor and the radiographer that you are taking chlorpromazine. Your doctor will probably tell you not to take chlorpromazine for 2 days before the myelogram and for one day after the myelogram.
• you should know that this medication may make you drowsy and may affect your thinking and movements. Do not drive a car or operate machinery until you know how this medication affects you.
• ask your doctor about the safe use of alcohol during your treatment with chlorpromazine. Alcohol can make the side effects of chlorpromazine worse.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Chlorpromazine may make your skin sensitive to sunlight.
• you should know that chlorpromazine may cause dizziness, lightheadedness, fast heartbeat, and fainting, especially when you get up too quickly from a lying position. This is most common at the beginning of treatment with chlorpromazine, especially after the first dose. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
• you should know that chlorpromazine may make it harder for your body to cool down when it gets very hot. Tell your doctor if you plan to do vigorous exercise or be exposed to extreme heat.

Unless your doctor tells you otherwise, continue your normal diet.

If you are taking chlorpromazine on a regular schedule and you miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Chlorpromazine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness, feeling unsteady, or having trouble keeping your balance
• blank facial expression
• shuffling walk
• restlessness
• agitation
• nervousness
• unusual, slowed, or uncontrollable movements of any part of the body
• difficulty falling asleep or staying asleep
• increased appetite
• weight gain
• breast milk production
• breast enlargement
• missed menstrual periods
• decreased sexual ability
• changes in skin color
• dry mouth
• stuffed nose
• difficulty urinating
• widening or narrowing of the pupils (black circles in the middle of the eyes)

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• fever
• muscle stiffness
• falling
• confusion
• fast or irregular heartbeat
• sweating
• yellowing of the skin or eyes
• flu-like symptoms
• sore throat, chills, and other signs of infection
• unusual bleeding or bruising
• neck cramps
• tongue that sticks out of the mouth
• tightness in the throat
• difficulty breathing or swallowing
• fine, worm-like tongue movements
• uncontrollable, rhythmic face, mouth, or jaw movements
• seizures
• blisters
• rash
• hives
• itching
• swelling of the eyes, face, mouth, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
• vision loss, especially at night
• seeing everything with a brown tint

Chlorpromazine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and your eye doctor. You should have regularly scheduled eye exams during your treatment with chlorpromazine because chlorpromazine may cause eye disease. Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking chlorpromazine. Chlorpromazine may interfere with the results of home pregnancy tests. Talk to your doctor if you think you might be pregnant during your treatment with chlorpromazine. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. ¶ This branded product is no longer on the market. Generic alternatives may be available.