Prochlorperazine

(proe klor per' a zeen)

PCI  : Contraindicated in pregnancy

LCI  : Contraindicated in lactation

Molecule Info

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WARNING

Increased Mortality in Elderly Patients with Dementia-Related Psychosis: Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Prochlorperazine maleate is not approved for the treatment of patients with dementia-related psychosis.

Indication(s) & Dosage

PROCHLORPERAZINE is indicated in-

Vertigo due to Meniere's Syndrome, labyrinthis and other causes, and for nausea and vomiting from whatever cause including that associated with migraine. It may also be used for schizophrenia (particularly in the chronic stage), acute mania and as an adjunct to the short-term management of anxiety.

Oral route

Vertigo
Adult: As maleate or mesilate: 15-30 mg daily, given in divided doses. May reduce gradually to 5-10 mg daily. Recommended buccal dose: 3-6 mg bid.

Prophylaxis of nausea and vomitting
Adult: As maleate or mesilate: 5-10 mg bid/tid. May also be given rectally. 

Nausea and vomiting
Adult: As maleate or mesilate: 20 mg, further doses are given if needed. Recommended buccal dose: As maleate: 3-6 mg bid.

Psychoses
Adult: As maleate or mesilate: 12.5 mg bid for 7 days, adjusted gradually to 75-100 mg daily according to response. Usual maintenance dose: 25-50 mg daily. 
Child: 1-5 yr: 1.25-2.5 mg; 5-12 yr: 2.5-5 mg. May be given up to tid, if necessary. 

Adjunct in severe anxiety disorders
Adult: As maleate or mesilate: 5-10 mg, up to 3-4 times daily. 
 
Intramuscular
Nausea and vomiting
Adult: As mesilate: 12.5 mg by deep IM. If required, may give further doses via oral admin. 
Intramuscular
Psychoses
Adult: As mesilate: 12.5-25 mg by deep IM Inj bid/tid.
Intravenous
Severe nausea and vomiting
Adult: As edisilate: 2.5-10 mg via slow IV inj or infusion at a rate not exceeding 5 mg/minute. Not to exceed 40 mg daily. 
Rectal
Nausea and vomiting
Adult: As base: 25 mg bid.
Rectal
Psychoses
Adult: As maleate: 25 mg bid/tid.

Administration May be taken with or without food.
Overdosage

Symptoms of phenothiazine overdosage include drowsiness or loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmias and hypothermia. Severe extrapyramidal dyskinesias may occur.

If the patient is seen sufficiently soon (up to 6 hours) after ingestion of a toxic dose, gastric lavage may be attempted. Pharmacological induction of emesis is unlikely to be of any use. Activated charcoal should be given. There is no specific antidote. Treatment is supportive.

Generalised vasodilatation may result in circulatory collapse; raising the patient's legs may suffice. In severe cases, volume expansion by intravenous fluids may be needed; infusion fluids should be warmed before administration in order not to aggravate hypothermia.

Positive inotropic agents such as dopamine may be tried if fluid replacement is insufficient to correct the circulatory collapse. Peripheral vasoconstrictor agents are not generally recommended. Avoid the use of adrenaline.

Ventricular or supraventricular tachy-arrhythmias usually respond to restoration of normal body temperature and correction of circulatory or metabolic disturbances. If persistent or life threatening, appropriate anti-arrhythmic therapy may be considered. Avoid lidocaine and, as far as possible, long acting anti-arrhythmic drugs.

Pronounced central nervous system depression requires airway maintenance or, in extreme circumstances, assisted respiration. Severe dystonic reactions usually respond to procyclidine (5-10 mg) or orphenadrine (20-40 mg) administered intramuscularly or intravenously. Convulsions should be treated with intravenous diazepam.

Neuroleptic malignant syndrome should be treated with cooling. Dantrolene sodium may be tried.

Contraindications CNS depression, comatose patients. Bone marrow depression, phaechromocytoma, prolactin-dependent tumours, hypersensitivity. Childn <2 yr. Pregnancy and lactation.
Special Precautions

Prochlorperazine should be avoided in patients with liver or renal dysfunction, Parkinson's disease, hypothyroidism, cardiac failure, phaeochromocytoma, myasthenia gravis, prostate hypertrophy. It should be avoided in patients known to be hypersensitive to phenothiazines or with a history of narrow angle glaucoma or agranulocytosis.

Close monitoring is required in patients with epilepsy or a history of seizures, as phenothiazines may lower the seizure threshold.

As agranulocytosis has been reported, regular monitoring of the complete blood count is recommended. The occurrence of unexplained infections or fever may be evidence of blood dyscrasia, and requires immediate haematological investigation.

It is imperative that treatment be discontinued in the event of unexplained fever, as this may be a sign of neuroleptic malignant syndrome (pallor, hyperthermia, autonomic dysfunction, altered consciousness, muscle rigidity). Signs of autonomic dysfunction, such as sweating and arterial instability, may precede the onset of hyperthermia and serve as early warning signs. Although neuroleptic malignant syndrome may be idiosyncratic in origin, dehydration and organic brain disease are predisposing factors.

Acute withdrawal symptoms, including nausea, vomiting and insomnia, have very rarely been reported following the abrupt cessation of high doses of neuroleptics. Relapse may also occur, and the emergence of extrapyramidal reactions has been reported. Therefore, gradual withdrawal is advisable.

In schizophrenia, the response to neuroleptic treatment may be delayed. If treatment is withdrawn, the recurrence of symptoms may not become apparent for some time.

Neuroleptic phenothiazines may potentiate QT interval prolongation which increases the risk of onset of serious ventricular arrhythmias of the torsade de pointes type, which is potentially fatal (sudden death). QT prolongation is exacerbated, in particular, in the presence of bradycardia, hypokalaemia, and congenital or acquired (i.e. drug induced) QT prolongation. The risk-benefit should be fully assessed before Prochlorperazine treatment is commenced. If the clinical situation permits, medical and laboratory evaluations (e.g. biochemical status and ECG) should be performed to rule out possible risk factors (e.g. cardiac disease; family history of QT prolongation; metabolic abnormalities such as hypokalaemia, hypocalcaemia or hypomagnesaemia; starvation; alcohol abuse; concomitant therapy with other drugs known to prolong the QT interval) before initiating treatment with Prochlorperazine and during the initial phase of treatment, or as deemed necessary during the treatment (see also sections 4.5 and 4.8).

Avoid concomitant treatment with other neuroleptics.

Stroke: In randomised clinical trials versus placebo performed in a population of elderly patients with dementia and treated with certain atypical antipsychotic drugs, a 3-fold increase of the risk of cerebrovascular events has been observed. The mechanism of such risk increase is not known. An increase in the risk with other antipsychotic drugs or other populations of patients cannot be excluded. Prochlorperazine should be used with caution in patients with stroke risk factors.

As with all antipsychotic drugs, Prochlorperazine should not be used alone where depression is predominant. However, it may be combined with antidepressant therapy to treat those conditions in which depression and psychosis coexist.

Because of the risk of photosensitisation, patients should be advised to avoid exposure to direct sunlight.

To prevent skin sensitisation in those frequently handling preparations of phenothiazines, the greatest care must be taken to avoid contact of the drug with the skin.

It should be used with caution in the elderly, particularly during very hot or very cold weather (risk of hyper-, hypothermia).

The elderly are particularly susceptible to postural hypotension.

Prochlorperazine should be used cautiously in the elderly owing to their susceptibility to drugs acting on the central nervous system and a lower initial dosage is recommended. There is an increased risk of drug-induced Parkinsonism in the elderly particularly after prolonged use. Care should also be taken not to confuse the adverse effects of Prochlorperazine, e.g. orthostatic hypotension, with the effects due to the underlying disorder.

Children: Prochlorperazine has been associated with dystonic reactions particularly after a cumulative dosage of 0.5 mg/kg. It should therefore be used cautiously in children

Increased Mortality in Elderly people with Dementia

Data from two large observational studies showed that elderly people with dementia who are treated with antipsychotics are at a small increased risk of death compared with those who are not treated. There are insufficient data to give a firm estimate of the precise magnitude of the risk and the cause of the increased risk is not known.

Prochlorperazine is not licensed for the treatment of dementia-related behavioural disturbances.

Cases of venous thromboembolism (VTE) have been reported with antipsychotic drugs. Since patients treated with antipsychotics often present with acquired risk factors for VTE, all possible risk factors for VTE should be identified before and during treatment with Prochlorperazine and preventative measures undertaken.

Hyperglycaemia or intolerance to glucose has been reported in patients treated with antipsychotic phenothiazines. Patients with an established diagnosis of diabetes mellitus or with risk factors for the development of diabetes who are started on Prochlorperazine, should get appropriate glycaemic monitoring during treatment.

Adverse Drug Reaction(s) Cholestatic jaundice, cardiac arrhythmias, orthostatic hypotension, leucopaenia, thrombocytopaenia, dry mouth, blurring of vision, glaucoma, urinary retention, constipation, galactorrhoea, gynaecomastia, amenorrhoea and impotence. Buccal: Transient numbness of gum and tongue.
Potentially Fatal: Bone-marrow suppression. Cardiac arrhythmias or aspiration.
Drug Interactions

Adrenaline must not be used in patients overdosed with Prochlorperazine.

The CNS depressant actions of neuroleptic agents may be intensified (additively) by alcohol, barbiturates and other sedatives. Respiratory depression may occur.

Anticholinergic agents may reduce the antipsychotic effect of neuroleptics and the mild anticholinergic effect of neuroleptics may be enhanced by other anticholinergic drugs, possibly leading to constipation, heat stroke, etc.

Some drugs interfere with absorption of neuroleptic agents: antacids, anti-Parkinson drugs and lithium.

Where treatment for neuroleptic-induced extrapyramidal symptoms is required, anticholinergic antiparkinsonian agents should be used in preference to levodopa, since neuroleptics antagonise the antiparkinsonian action of dopaminergics.

High doses of neuroleptics reduce the response to hypoglycaemic agents, the dosage of which might have to be raised.

The hypotensive effect of most antihypertensive drugs especially alpha adrenoceptor blocking agents may be exaggerated by neuroleptics.

The action of some drugs may be opposed by phenothiazine neuroleptics; these include amfetamine, levodopa, clonidine, guanethidine, adrenaline.

Increases or decreases in the plasma concentrations of a number of drugs, e.g. propranolol, phenobarbital have been observed but were not of clinical significance.

Simultaneous administration of desferrioxamine and prochlorperazine has been observed to induce transient metabolic encephalopathy characterised by loss of consciousness for 48-72 hours.

There is an increased risk of arrhythmias when neuroleptics are used with concomitant QT prolonging drugs (including certain antiarrhythmics, antidepressants and other antipsychotics) and drugs causing electrolyte imbalance.

There is an increased risk of agranulocytosis when neuroleptics are used concurrently with drugs with myelosuppressive potential, such as carbamazepine or certain antibiotics and cytotoxics.

In patients treated concurrently with neuroleptics and lithium, there have been rare reports of neurotoxicity.

Pregnancy Category (FDA) Category C

There is inadequate evidence of safety in pregnancy. There is evidence of harmful effects in animals. Prochlorperazine should be avoided in pregnancy unless the physician considers it essential. Neuroleptics may occasionally prolong labour and at such time should be withheld until the cervix is dilated 3-4 cm. Possible adverse effects on the neonate include lethargy or paradoxical hyperexcitability, tremor and low apgar score.

Neonates exposed to antipsychotics (including Prochlorperazine) during the third trimester of pregnancy are at risk of adverse reactions including extrapyramidal and/or withdrawal symptoms that may vary in severity and duration following delivery. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, or feeding disorder. Consequently, newborns should be monitored carefully.

Phenothiazines may be excreted in milk, therefore breast feeding should be suspended during treatment.

Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Storage Intramuscular: Store below 30°C. Rectal: Store at 15-30°C.
Pharmacology Prochlorperazine blocks both postsynaptic dopamine receptors as well as the medullary chemo receptor trigger zone. It depresses hypothalamic and hypophyseal hormone release and posssesses α-adrenergic and anticholinergic inhibitory activity.
ATC Classification N05AB04 - prochlorperazine; Belongs to the class of phenothiazine antipsychotics with piperazine structure. Used in the management of psychosis.

Brand/Product Info


Total Products : 12            
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
AVOTIL Rephco Laboratories Ltd. Prochlorperazine maleate 5mg Tablet 100's: 30.00 MRP
EMITAB Sonear Laboratories Ltd. Prochlorperazine maleate 5mg Tablet 100's: 46.00 MRP
MELATIL Gaco Pharmaceutical Ltd. Prochlorperazine maleate 5mg Tablet 100's: 27.83 MRP
MELATIL Injection Gaco Pharmaceutical Ltd. Prochlorperazine mesilate 12.5mg/ml Injection 1 amp: 3.54 MRP
PROMAT Navana Pharmaceuticals Limited Prochlorperazine maleate 5mg Tablet 200's: 58.00 MRP
PROMTIL 5 Square Pharmaceuticals Ltd. Prochlorperazine Maleate 5mg Tablet 15x20's: 135.00 MRP
STEMETIL Sanofi Prochlorperazine maleate 5mg Tablet 500's: 230.02 MRP
STEMETIL Injection Sanofi Prochlorperazine mesilate 12.5mg/ml Injection 1ml x10's: 50.27 MRP
VERGON Opsonin Pharma Limited Prochlorperazine maleate 5mg Tablet 400's: 184.00 MRP
VERGON Injection Opsonin Pharma Limited Prochlorperazine mesilate 12.5mg/1ml Injection 1ml amp x50's: 250.00 MRP
VERGON Syrup Opsonin Pharma Limited Prochlorperazine maleate 5mg/5ml Syrup 100ml: 68.79 MRP
VERTIGAN Pharmadesh Laboratories Limited Prochlorperazine maleate 5mg Tablet 500's: 200.00 MRP

Gen. MedInfo

IMPORTANT WARNING:

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 prochlorperazine have an increased chance of death during treatment.

Prochlorperazine is not approved by the Food and Drug Administration (FDA) for the treatment of behavior problems in older adults with dementia. Talk to the doctor who prescribed this medication if you, a family member, or someone you care for has dementia and is taking prochlorperazine. For more information, visit the FDA website: http://www.fda.gov/Drugs

Why is this medication prescribed?

Prochlorperazine suppositories and tablets are used to control severe nausea and vomiting. Prochlorperazine tablets are also 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). Prochlorperazine tablets are also used on a short-term basis to treat anxiety that could not be controlled by other medications. Prochlorperazine should not be used to treat any condition in children who are younger than 2 years old or who weigh less than 20 pounds (about 9 kilograms). Prochlorperazine is in a class of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain.

How should this medicine be used?

Prochlorperazine may come as a tablet to take by mouth and as a suppository to place in the rectum. Prochlorperazine tablets are usually taken three to four times a day by adults and are usually given to children one to three times a day. Prochlorperazine suppositories are usually inserted twice a day. Use prochlorperazine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use prochlorperazine exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your doctor may start you on a low dose of prochlorperazine and gradually increase your dose, not more often than once every 2-3 days.

If you are using prochlorperazine to treat schizophrenia, prochlorperazine may help control your symptoms but will not cure your condition. Continue to use prochlorperazine even if you feel well. Do not stop using prochlorperazine without talking to your doctor. If you suddenly stop using prochlorperazine, you may experience withdrawal symptoms such as nausea, vomiting, dizziness, and shakiness.

To insert a prochlorperazine suppository, follow these steps:

  1. Wash your hands thoroughly with soap and water.

  2. If the suppository is soft, hold it under cool water or place it in the refrigerator for a few minutes to harden it before removing the wrapper.

  3. Remove the wrapper, if present.

  4. If you were told to use half of the suppository, cut it lengthwise with a clean, sharp blade.

  5. Put on a finger cot or disposable glove, if desired (available at a pharmacy).

  6. Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water.

  7. Lie on your side with your lower leg straightened out and your upper leg bent forward toward your stomach.

  8. Lift upper buttock to expose the rectal area.

  9. Insert the suppository, pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1/2 to 1 inch (1.25 to 2.5 centimeters) in infants and 1 inch (2.5 centimeters) in adults. If not inserted past this sphincter, the suppository may pop out.

  10. Hold buttocks together for a few seconds.

  11. Remain lying down for about 15 minutes to avoid having the suppository come out.

  12. Try to avoid having a bowel movement for about an hour so that the medication in the suppository can be absorbed into the body.

  13. Discard used materials and wash your hands thoroughly.

Other uses for this medicine

 

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using prochlorperazine,
  • tell your doctor if you are allergic to prochlorperazine, other phenothiazines such as chlorpromazine, fluphenazine, perphenazine, promethazine (Phenergan), thioridazine, and trifluoperazine; or any other medications. If you will be taking prochlorperazine tablets, also tell your doctor if you are allergic to tartrazine (a yellow dye found in some foods and medications) or aspirin.
  • tell your doctor 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; antidepressants; antihistamines; atropine; barbiturates such as pentobarbital (Nembutal), phenobarbital (Luminal), and secobarbital (Seconal); diuretics ('water pills'); epinephrine (Epipen); guanethidine; ipratropium; lithium, medications for anxiety, mental illness, Parkinson's disease, motion sickness, 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 glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision), seizures, an abnormal electroencephalogram (EEG; test that measures electrical activity in the brain), brain damage, pheochromocytoma (tumor on a small gland near the kidneys), breast cancer, any condition that affects the production of blood cells by your bone marrow, or heart disease. Also tell your doctor if you have ever had to stop taking a medication for mental illness due to severe side effects and if you plan to work with organophosphorus insecticides (a type of chemical used to kill insects).
  • if you will be giving prochlorperazine to a child, tell the child's doctor if the child has chickenpox, measles, a stomach virus, or an infection of the brain or spinal cord. Also tell the child's doctor if the child has any of the following symptoms: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. Be sure to tell the child's doctor if the child has not been drinking normally, has excessive diarrhea, or appears dehydrated.
  • if you will be using prochlorperazine 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 prochlorperazine.
  • 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 prochlorperazine, call your doctor. Ptrochlorperazine 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 using prochlorperazine.
  • if you will be having a myelogram (x-ray examination of the spine), tell your doctor and the radiographer that you are taking prochlorperazine. Your doctor will probably tell you not to take prochlorperazine 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, especially at the beginning of your treatment. 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 prochlorperazine. Alcohol can make the side effects of prochlorperazine worse.
  • you should know that prochlorperazine may cause dizziness, especially when you get up from a lying position. 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 prochlorperazine 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.

What special dietary instructions should I follow?

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

What should I do if I forget 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.

What side effects can this medication cause?

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

  • dizziness

  • blurred vision

  • dry mouth

  • stuffed nose

  • headache

  • nausea

  • constipation

  • difficulty urinating

  • widening or narrowing of the pupils (black circles in the center of the eyes)

  • increased appetite

  • weight gain

  • agitation

  • jitteriness

  • difficulty falling asleep or staying asleep

  • blank facial expression

  • drooling

  • uncontrollable shaking of a part of the body

  • shuffling walk

  • breast enlargement

  • breast milk production

  • missed menstrual periods

  • decreased sexual ability in men

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

  • fever

  • muscle stiffness

  • confusion

  • fast or irregular heartbeat

  • sweating

  • yellowing of the skin or eyes

  • flu-like symptoms

  • sore throat, chills, and other signs of infection

  • 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

  • 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

  • coma (loss of consciousness for a period of time)

  • erection that lasts for hours

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

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store prochlorperazine suppositories in their wrappers; do not unwrap a suppository until just before you insert it. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.

Symptoms of overdose may include:

  • agitation

  • jitteriness

  • difficulty falling asleep or staying asleep

  • blank facial expression

  • drooling

  • uncontrollable shaking of a part of the body

  • shuffling walk

  • sleepiness

  • coma (loss of consciousness for a period of time)

  • seizures

  • irregular heartbeat

  • fever

  • dry mouth

  • constipation

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

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.

Ref:  U.S. National Library of Medicine.


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

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