Chlorpromazine
- Atc Codes:N05AA01
- CAS Codes:50-53-3#69-09-0
- PHARMGKB ID:50-53-3#69-09-0
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Bulgaria: Chlorpromazine; Cyprus: Chlorpromazine; Czech Republic: Plegomazin; Finland: Klorproman; France: Largactil; Greece: Solidon, Zuledine; Hungary: Hibernal; Ireland: Chlorpromazine, Clonactil; Italy: Clorpr C, Largactil, Prozin; Latvia: Aminazīns; Luxembourg: Largactil; Malta: Chlorpromazine, Largactil; Poland: Fenactil; Portugal: Largactil; Romania: Plegomazin; Slovakia: Plegomazin; Spain: Largactil; UK: Chlorpromazine, Largactil.
North America
Canada: Chlorpromazine; USA: Chlorpromazine.
Latin America
Argentina: Ampliactil, Conrax, Clorpromacina, Clorpromazina; Brazil: Amplictil, Clopsina, Clorpromaz, Longactil; Mexico: Largactil.
Asia
Japan: Contomin, Wintermin.
Drug combinations
Chlorpromazine, Procaine, Pyridoxine (Vitamin B~6~), and Scopolamine
Chemistry
Chlorpromazine: C~17~H~19~ClN~2~S. Mw: 318.86. (1) 10H-Phenothiazine-10-propanamine, 2-chloro-N,N-dimethyl-; (2) 2-Chloro-10-[3-(dimethylamino)propyl]phenothiazine. CAS-50-53-3.
Chlorpromazine Hydrochloride: C~17~H~19~ClN~2~S HCl. Mw: 355.33. 2-Chloro-10-[3-(dimethylamino)propyl]phenothiazine monohydrochloride. CAS-69-09-0.
Pharmacologic Category
Antipsychotics; Phenothiazines. (ATC-Code: N05AA01).
Mechanism of action
Chlorpromazine is an aliphatic phenothiazine antipsychotic which blocks postsynaptic mesolimbic dopaminergic receptors in the brain. Has actions at all levels of CNS, particularly at subcortical levels; also acts on multiple organ systems. Exhibits strong anticholinergic effects and sedative effects and moderate extrapyramidal effects; has strong antiemetic activity. Also exhibits weak ganglionic blocking, antihistaminic, and antiserotonergic activity. Has a strong α-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones. Depresses the reticular activating system, thus affecting basal metabolism, body temperature, wakefulness, vasomotor tone, and emesis. Precise mechanism(s) of antipsychotic action not determined, but may be principally related to antidopaminergic effects.
Therapeutic use
Mania. Schizophrenia. Nausea and vomiting. Relief of restlessness and apprehension before surgery. Acute intermittent porphyria. Adjunct in the treatment of tetanus. Intractable hiccups. Combativeness and/or explosive hyperexcitable behavior in children 1-12 years of age. Hyperactive children.
Pregnancy and lactiation implications
Use not recommended during lactation. Drowsiness and lethargy reported in nursing infants. Galactorrhea reported in mother.
Unlabeled use
Psychotic disorders. Behavioral symptoms associated with dementia (elderly). Psychosis/agitation related to Alzheimer’s dementia.
Contraindications
Hypersensitivity to chlorpromazine or any component of the formulation (cross-reactivity between phenothiazines may occur). Severe CNS depression. Coma.
Warnings and precautions
May alter cardiac conduction (risk of life-threatening arrhythmias). Use with caution in severe cardiovascular disease. May cause orthostatic hypotension (caution if cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention; caution in decreased gastrointestinal motility, paralytic ileus, urinary retention, BPH, xerostomia, or visual problems). Antipsychotic use has been associated with esophageal dysmotility and aspiration (caution if risk of pneumonia). May cause extrapyramidal symptoms, including pseudoparkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesia (caution in the elderly). May be associated with neuroleptic malignant syndrome (higher risk if Parkinson’s disease or Lewy body dementia). Highly sedating. Use with caution in patients at risk of seizures (history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy which may lower seizure threshold). Use with caution in myasthenia gravis (may be exacerbated by cholinergic blockade). Elderly patients with dementia-related psychosis treated with antipsychotics are at increased risk of death compared to placebo (risk of cerebrovascular events). Effects may be potentiated when used with other sedative drugs or ethanol. May be associated with pigmentary retinopathy. Use with caution in narrow-angle glaucoma (may be exacerbated by cholinergic blockade). Impaired core body temperature regulation may occur. Use with caution in bone marrow suppression (risk of blood dyscrasias). Use with caution in hepatic/renal/respiratory impairment. Use with caution in breast cancer or other prolactin-dependent tumors (elevates prolactin levels). May mask toxicity of other drugs or conditions (e.g. intestinal obstruction, Reye’s syndrome, brain tumor) due to antiemetic effects. Injection contains sulfites. May cause false-positives for phenylketonuria, amylase, uroporphyrins, urobilinogen. May cause false-positive pregnancy test.