Other drugs that ACOG recommends for morning sickness include: dimenhydrinate (Dramamine, Gravol), diphenhydramine (Benadryl), prochlorperazine (Compro), and promethazine (Phenergan).
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Based on effectiveness, side effects, and other factors, the research team recommended that one of three drugs be tried first - metoclopramide, prochlorperazine, or sumatriptan – because each had solid data to support its use.
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Prochlorperazine is another commonly prescribed medication to help alleviate the symptoms of vertigo and nausea.
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Intravenous metoclopramide, intravenous prochlorperazine, or intranasal lidocaine are other potential options. Metoclopramide or prochlorperazine are the recommended treatment for those who present to the emergency department. Haloperidol may also be useful in this group. A single dose of intravenous dexamethasone, when added to standard treatment of a migraine attack, is associated with a 26% decrease in headache recurrence in the following 72 hours.
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In the UK prochlorperazine maleate has been used for labyrinthitis, which include not only nausea and vertigo, but spatial and temporal 'jerking' and distortion.
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Alexza Pharmaceuticals studied an inhaled form of prochlorperazine for the treatment of migraine through Phase II trials under the development name AT-001; development was discontinued in 2011.
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Phenothiazines, often used for the treatment of nausea and vomiting, are also effective for treating migraine headache. Prochlorperazine is typically used due to a more favorable treatment profile.
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With respect to medications, pyridoxine or metoclopramide are preferred. Prochlorperazine, dimenhydrinate, ondansetron (sold under the brand-name Zofran) or corticosteroids may be used if these are not effective. Hospitalization may be required. Psychotherapy may improve outcomes.
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Prochlorperazine is used to prevent vomiting caused by chemotherapy, radiation therapy and in the pre- and postoperative setting. A 2015 Cochrane review found no differences in efficacy among drugs commonly used for this purpose in emergency rooms.
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Prochlorperazine is available as tablets, suppositories, and in an injectable form. As of September 2017 it was marketed under the trade names Ametil, Antinaus, Buccastem, Bukatel, Chlormeprazine, Chloropernazine, Compazine, Compro, Daolin, Dhaperazine, Emedrotec, Emetiral, Eminorm, Lotamin, Mitil, Mormal, Nautisol, Novamin, Novomit, Proazine, Procalm, Prochlorperazin, Prochlorperazine, Prochlorpérazine, Prochlorperazinum, Prochlozine, Proclorperazina, Promat, Promin, Promtil, Roumin, Scripto-metic, Seratil, Stemetil, Steremal, Vergon, Vestil, and Volimin. It was also marketed at that time as a combination drug for humans with paracetamol as Vestil-A, as a combination drug for veterinary use, with isopropamide as Darbazine.
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Prochlorperazine, generally by intravenous, is used to treat migraine. Such use is recommended by The American Headache Society. Compared with metoclopramide, PCP had an almost 3 times higher odds of headache relief within the 60 minutes of PCP administration.
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Hearing loss has been reported in Ebola survivors 25% of the time. Treatment, in the case of acute labyrinthitis (inner ear disorder), should be given within 10 days of the onset of symptoms and prochlorperazine, a vestibular sedative, may be administered for vertigo.
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Symptomatic treatment with anti-emetics and medications for the hiccups are important. Commonly used anti-emetics include ondansetron, metoclopramide, prochlorperazine, and promethazine. These medications are also used to treat hiccups, along with chlorpromazine. There are case reports of other medications useful in treating hiccups in Wallenberg's Syndrome including baclofen and anti-epileptic medications.
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In the UK, prochlorperazine is available for the treatment of nausea caused by migraine as a tablet dissolved in the mouth, and in Australia as a tablet swallowed whole. It is sold as a "pharmacy medicine", meaning it does not require a prescription but is only available after talking with a pharmacist.
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Serious side effects may include movement disorders including tardive dyskinesia and neuroleptic malignant syndrome. Use in pregnancy and breastfeeding is generally not recommended. It is a typical antipsychotic which is believed to work by affecting levels of dopamine in the brain. Prochlorperazine was approved for medical use in the United States in 1956.
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Prochlorperazine, sold under the brand name Compazine among others, is a medication used to treat nausea, schizophrenia, migraines, and anxiety. It is a less preferred medication for anxiety. It may be taken by mouth, rectally, injection into a vein, or injection into a muscle. Common side effects include sleepiness, blurry vision, low blood pressure, and dizziness.
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U.S. Review of Prescription Drugs Ends, The New York Times, September 16, 1984, Page 52. Eskatrol contained dextroamphetamine sulfate (Dexedrine)Pharmacist Arrested on Drug Charge, Los Angeles Times, July 16, 1975, Page A3. and prochlorperazine (Compazine), a typical antipsychotic. In August 1970 the FDA sought to limit the use of stimulants by calling for changes in labeling which decreased the number of allowable claims and intensified the warnings about possible hazards.
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A steady-state plasma level of dofetilide is achieved in 2–3 days. 80% of dofetilide is excreted by the kidneys, so the dose of dofetilide should be adjusted in individuals with chronic kidney disease, based on creatinine clearance. In the kidneys, dofetilide is eliminated via cation exchange (secretion). Agents that interfere with the renal cation exchange system, such as verapamil, cimetidine, hydrochlorothiazide, itraconazole, ketoconazole, prochlorperazine, and trimethoprim should not be administered to individuals taking dofetilide.
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Sedation is very common, and extrapyramidal side effects are common and include restlessness, dystonic reactions, pseudoparkinsonism, and akathisia; the extrapyramidal symptoms can affect 2% of people at low doses, whereas higher doses may affect as many as 40% of people. Prochlorperazine can also cause a life-threatening condition called neuroleptic malignant syndrome (NMS). Some symptoms of NMS include high fever, stiff muscles, neck muscle spasm, confusion, irregular pulse or blood pressure, fast heart rate (tachycardia), sweating, abnormal heart rhythms (arrhythmias). Research from the Veterans Administration and United States Food and Drug Administration show injection site reactions.
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Medical cannabis is somewhat effective in chemotherapy-induced nausea and vomiting (CINV) and may be a reasonable option in those who do not improve following preferential treatment. Comparative studies have found cannabinoids to be more effective than some conventional antiemetics such as prochlorperazine, promethazine, and metoclopramide in controlling CINV, but these are used less frequently because of side effects including dizziness, dysphoria, and hallucinations. Long-term cannabis use may cause nausea and vomiting, a condition known as cannabinoid hyperemesis syndrome (CHS). A 2016 Cochrane review said that cannabinoids were "probably effective" in treating chemotherapy-induced nausea in children, but with a high side-effect profile (mainly drowsiness, dizziness, altered moods, and increased appetite).
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Buccal administration is a topical route of administration by which drugs held or applied in the buccal () area (in the cheek) diffuse through the oral mucosa (tissues which line the mouth) and enter directly into the bloodstream. Buccal administration may provide better bioavailability of some drugs and a more rapid onset of action compared to oral administration because the medication does not pass through the digestive system and thereby avoids first pass metabolism. As of May 2014, the psychiatric drug asenapine; the opioid drugs buprenorphine, naloxone, and fentanyl; the cardiovascular drug nitroglycerin; the nausea medication Prochlorperazine; the hormone replacement therapy testosterone; and nicotine as a smoking cessation aid were commercially available in buccal forms, as was midazolam, an anticonvulsant, used to treat acute epileptic seizures. Buccal administration of vaccines has been studied, but there are challenges to this approach due to immune tolerance mechanisms that prevent the body from over-reacting to immunogens encountered in the course of daily life.
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