LARGACTIL
CHLORPROMAZINE · by SANOFI-AVENTIS
Composition
Inj: Per ml: Chlorpromazine HCI 25 mg; 2 ml amp. Syrup per 5 ml. Chlorpromazine HCI 25 mg. Tab-10 mg/25 mg/50 mg/100 mg: Chlorpromazine HCI 10 mg/25 mg/50 mg/100 mg.
Indications & Dosage
Schizophrenia and other psychoses, Mania, Severe anxiety (short-term), Psychomotor agitation, excitement, and violent or dangerously impulsive behavior: ORAL: Adult: Initially 25 mg 3 times a day, adjusted according to response, alternatively initially 75 mg once daily at night, adjusted according to response; maintenance 75-300 mg daily, increased if necessary up to 1 g daily, this dose may be required in psychoses; use a third to half adult dose in the elderly or debilitated patients. Children1-6 yrs: 500 mcg/kg every 4-6 hr adjusted according to response, max 40 mg/day; 6-12 yrs: 10 mg 3 times daily, adjusted according to response, max 75 mg/day; 12-18 yrs: 25 mg 3 times daily or 75 mg at night, adjusted according to response, to usual maintenance dose of 75-300 mg daily (up to 1 gm daily may be required). Intractable hiccup: ORAL: Adult: 25-50 mg 3-4 times a day. Relief of acute symptoms of psychoses: BY DEEP IM INJ: Adult: 25-50 mg every 6-8 hours. Children 1-6 yr: 500 mcg/kg every 6-8 hr, max 40 mg day; 6-12 yr: 500 mcg/kg every 6-8 hr, max 75 mg day; 12-18 yr: 25-50 mg every 6-8 hr until vomiting stops. Nausea and vomiting of terminal illness (where other drugs have failed or inappropriate): ORAL: Adult: 10-25 mg every 4-6 hours Children 1-5 yrs: 500 mcg/kg every 4-6 hrs; max. 40 mg per day; 6-11 years: 500 mcg/kg every 4-6 hrs; max. 75 mg per day; 12-17 yrs: 10-25 mg every 4-6 hours BY DEEP IM INJ: Adult: Initially 25 mg, then 25-50 mg every 3-4 hoursuntil vomiting stops. Children 1-5 yrs: 500 mcg/kg every 6-8 hours; max. 40 mg per day; 6-11 yrs: 500 mcg/kg every 6-8 hours; max. 75 mg per day; 12-17 yrs: Initially 25 mg, then 25-50 mg every3-4 hours until vomiting stops.
Administration
Direct of intermittent infusion: Infuse 1 mg or portion thereof over 1 min. Note: Avoid skin contact with soln; may cause contact dermatitis. Diluted injection (1 mg/ ml) with NS remain stable for 30 days. Dilute injection (1 mg/ml) with NS for IV administration. Slowly and deep IM injection into upper outer quadrant of buttocks, such as in the gluteus maximus, to minimize hypotensive effects, keep patient lying flat and monitor blood pressure for 30 mins after injection.
Compatibility
Stable in dextran 6% in dextrose, dextran 6% in NS, D5LR, D5 1/2 NS, D5 1/2 NS, D5NS, D5W, 010W, LR, 0.45% NS, NS.
Stability
Protect from light. Diluted injection (1 mg/ml) with NS and stored in 5 ml vials remains stable for 30 days.
Contraindications
CNS depression, comatose states, hypothyroidism, phaeochromocytoma, bone marrow depression,
Precautions
Cardiovascular diseases, renal and hepatic impairment, Parkinsonism, epilepsy.
Interactions
Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, do-paminergics, lithium, oral hypoglycaemics, antihypertenaives, anticonvulsants, desferrioxamine, propranolol, drugs that prolonged the QT interval (e.g. anti-arrhythmics), mye-losuppressive drugs, metoclopramide.
Pregnancy
Contraindicated
Lactation
Contraindicated
Side Effects
Acute dystonic reactions such as facial and skeletal muscle spasms and oculogyric crises, leucopenia, hyperprolactinaemia, acute dyskinesias, akathisia, Parkinsonism, drowsiness, insomnia, agitation, tachycardia, arrhythmias; ECG changes, hypotension, antieholinergic effects (e.g. dry mouth, blurred vision), respiratory depression, rash, photosensitivity, hypoglycaemia, impaired tem-perature regulation, convulsions, male sexual dysfunction, rarely, agranulocytosis, tardive dyskinesia, jaundice, neuroleptic malignant syndrome, pigmentary retinopathy