Gevril

Indications

Chlorpromazine Hydrochloride is an older antipsychotic medicine. It is used to treat schizophrenia and other psychoses (conditions in which a person loses touch with reality, with hallucinations or fixed false beliefs), mania, and severe agitation or anxiety. It is also used to control severe nausea and vomiting and stubborn hiccups that have not responded to other treatment. It is prescribed by a doctor, often a psychiatrist.

How It Works

Chlorpromazine blocks dopamine receptors in the brain, which reduces hallucinations, delusions and agitation. Blocking dopamine in the vomiting centre of the brain also reduces nausea. It blocks histamine, serotonin and other receptors too, which explains its calming effect and several of its side effects.

Dosage and Administration

The dose depends on the condition, age and response, and is adjusted gradually by the doctor; take exactly as prescribed. Doses for older people are usually lower. Injections are given by a doctor or nurse. Do not stop suddenly after long use, as this may cause withdrawal symptoms or a return of the illness; your doctor will reduce the dose slowly.

Interactions

Chlorpromazine increases drowsiness with alcohol, opioid painkillers, sleeping tablets and Benzodiazepines. Medicines that affect heart rhythm, such as Amiodarone, Erythromycin, Haloperidol, Methadone and Citalopram, should be avoided. It can lower blood pressure further when taken with blood pressure medicines. It may reduce the effect of Levodopa and other Parkinson's medicines. Antacids can reduce its absorption. Tell your doctor about all medicines you take, including Lithium and seizure medicines.

Contraindications

Do not take if you are allergic to Chlorpromazine or other phenothiazines, if you are in a coma or very drowsy from alcohol or other sedating medicines, or if you have bone marrow failure. It is generally avoided in people with phaeochromocytoma, narrow-angle glaucoma and severe liver disease.

Side Effects

• Drowsiness, dizziness and low blood pressure on standing
• Dry mouth, blurred vision and constipation
• Weight gain
• Shaking, stiffness, restlessness or abnormal movements
• Increased sensitivity of the skin to sunlight
• Changes in periods or breast swelling

Get urgent medical help if you have high fever with stiff muscles, sweating and confusion (neuroleptic malignant syndrome), fainting or a fast or irregular heartbeat, yellowing of the skin or eyes, sore throat with fever or mouth ulcers (signs of low white cells), uncontrolled movements of the face or tongue, or fits.

Pregnancy and Lactation

Use in pregnancy only if a doctor decides it is essential, as use late in pregnancy can cause movement problems and withdrawal symptoms in the newborn. It passes into breast milk and is usually avoided during breastfeeding.

Precautions and Warnings

Older people with dementia have a higher risk of stroke and death with antipsychotics. Use with care in people with heart disease, epilepsy, Parkinson's disease, liver or kidney disease, prostate enlargement or diabetes. Avoid strong sunlight and use sun protection. Do not drive or operate machines if you feel drowsy, and avoid alcohol. Avoid overheating in hot weather.

Overdose

Overdose can cause deep sleep or coma, low blood pressure, low body temperature, abnormal heart rhythm, abnormal movements and fits. Seek emergency medical help immediately.

Therapeutic Class

Antipsychotic (typical, phenothiazine type), also used as an antiemetic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored as directed on the pack.