Proziere (prochlorperazine)

How does it work?

Proziere tablets contain the active ingredient prochlorperazine, which is a type of medicine called a phenothiazine. (NB. prochlorperazine is also available without a brand name, ie as the generic medicine.) Prochlorperazine has two quite different uses. In higher doses it is used in the treatment of psychiatric illnesses. In lower doses it is used in the management of nausea and vomiting.

When used in psychiatric illness, prochlorperazine is sometimes described as a neuroleptic or a 'major tranquilliser'. However this last term is fairly misleading, as this type of medicine is not just a tranquilliser, and any tranquillising effect is not as important as its main mechanism of action in psychiatric illness.

Prochlorperazine works by blocking dopamine receptors in the brain. Dopamine is a natural compound called a neurotransmitter, and is involved in transmitting messages between brain cells. Dopamine is a neurotransmitter known to be involved in regulating mood and behaviour, amongst other things.

Psychotic illness, and particularly schizophrenia, is thought to be caused by overactivity of dopamine in the brain. Prochlorperazine blocks the receptors that dopamine acts on, and this prevents the overactivity of dopamine in the brain. This helps to control psychotic illness.

Prochlorperazine is used in the long-term management of psychotic conditions such as schizophrenia. It is also used in the short-term to manage severe anxiety or acute mania.

Prochlorperazine also affects dopamine receptors in an area of the brain that controls nausea and vomiting. Vomiting is controlled by an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness (nausea) and for the vomiting reflex. It is activated when it receives nerve messages from another area of the brain called the chemoreceptor trigger zone (CTZ) and when it receives nerve messages from the gut.

Prochlorperazine controls nausea and vomiting by blocking dopamine receptors found in the CTZ. This stops the CTZ from sending the messages to the vomiting centre that would otherwise cause nausea and vomiting.

What is it used for?

In adults:

Psychotic illness such as schizophrenia

Acute mania

Short-term treatment of severe anxiety

Treatment and prevention of nausea and vomiting

Relieving nausea, vomiting and attacks of dizziness or spinning sensations (vertigo) associated with Meniere's disease and other inner ear disorders.

In children aged over one year and weighing more than 10kg:

Treatment and prevention of nausea and vomiting.

Warning!

This medicine may cause drowsiness. If affected do not drive or operate machinery. Alcohol should be avoided because it can make drowsiness worse.

This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass.

This medicine may make your skin more sensitive to sunlight than it usually is, so you should avoid exposing your skin to direct sunlight or sunlamps until you know how your skin reacts. If you can't avoid strong sunlight you should use a sunscreen lotion or make sure your skin is protected with clothing.

If you have been taking high doses of this medicine for a long time, for example to treat schizophrenia, you should not suddenly stop taking it unless your doctor tells you to, even if you feel better and think you don't need it any more. This is because the medicine controls the symptoms of the illness but doesn't actually cure it. This means that if you suddenly stop treatment your symptoms could come back. Stopping the medicine suddenly may also rarely cause withdrawal symptoms such as nausea, vomiting, difficulty sleeping or tremor. When treatment with this medicine is stopped, it should be done gradually, following the instructions given by your doctor.

This medicine may rarely cause a decrease in the normal amounts of white blood cells in the blood. For this reason, if you are taking high doses of this medicine for a long time your doctor may want you to have regular blood tests to check the levels of blood cells in your blood. You should consult your doctor immediately if you experience any of the following symptoms while taking this medicine, as they may indicate a problem with your blood cells: unexplained sore throat, mouth ulcers, infections, high temperature (fever) or general illness.

Consult your doctor immediately if you experience the following symptoms while taking this medicine: high temperature (fever), pale complexion, sweating, muscle stiffness, fast heartbeat and decreased consciousness. These symptoms may be due to a rare but serious side effect of this type of medicine, known as the neuroleptic malignant syndrome, and your treatment may need to be stopped.

Use with caution in

Elderly people

Decreased kidney function

Decreased liver function

Heart disease

People with an abnormal heart rhythm seen on a heart monitoring trace as a 'prolonged QT interval'

Low levels of potassium, calcium or magnesium in the blood (hypokalaemia, hypocalcaemia or hypomagnesaemia)

Malnutrition

Dehydration

Alcohol abuse

Underactive thyroid gland

Tumour of the adrenal gland (phaeochromocytoma)

Enlarged prostate gland

Parkinson's disease

Abnormal muscle weakness

History of seizures (fits) eg epilepsy

History of closed angle glaucoma

History of a drop in the normal number of white blood cells in the blood

Allergy to other phenothiazine medicines, eg chlorpromazine, trifluoperazine.

Not to be used in

Children (except for the management of nausea and vomiting - see above)

Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established. It should not be used in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

This medicine passes into breast milk. It should not be used in women who are breastfeeding. Mothers who need to take this medicine should not breastfeed during treatment. Seek medical advice from your doctor.

Label warnings

This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.

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