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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by xbunny on May 18, 2005, at 11:37:00
My mum has been prescribed this for severe nausea and it seems to be giving her that crawling out your skin feeling (akathisia?) and making her act a bit loopy. Just for my own curiousity 5mg three times a day is equivalent to how much chlorpromazine?
Posted by ed_uk on May 18, 2005, at 13:02:48
In reply to Prochlorperazine potency, posted by xbunny on May 18, 2005, at 11:37:00
Hi Bunny,
There is no established 'equivalent' dose. It has been estimated that 2.5-5.0mg prochlorperazine may have similar antipsychotic efficacy to chlorpromazine 25mg. This should *not* be taken too seriously, very little information is available! 'Equivalent' doses are inaccurate at best and can be very misleading. Prochlorperazine is more likely to cause akathisia than chlorpromazine.
The usual (oral) dose of prochlorperazine for severe nausea is 5-10mg two or three times a day.
I think your mum should get a different antiemetic! There are many options.
Kind regards,
Ed.
Posted by xbunny on May 18, 2005, at 13:58:04
In reply to Re: Prochlorperazine potency » xbunny, posted by ed_uk on May 18, 2005, at 13:02:48
Hi Ed, thanks for that, just what I needed to know.
Buns
Posted by ed_uk on May 18, 2005, at 15:12:51
In reply to Re: Prochlorperazine potency, posted by xbunny on May 18, 2005, at 13:58:04
Hi Buns,
I hope you don't mind me asking. What is the cause of her nausea?
Ed.
Posted by yxibow on May 18, 2005, at 18:04:59
In reply to Re: Prochlorperazine potency » xbunny, posted by ed_uk on May 18, 2005, at 13:02:48
> I think your mum should get a different antiemetic! There are many options.
>
> Kind regards,
> Ed.I would agree.. depending on where she lives, there are much newer drugs, the 5HT3 antagonists, ondansetron (Zofran), the first, and the newer ones granisetron (Kytril) and dolasetron (Anzemet), which are used in chemotherapy and postoperative nausea and also in conjunction with HIV drug therapy among others. They are more expensive than the phenothiazine or related neuroleptic antiemetics but they dont carry the risk of EPS and especially tardive dyskinesia which in the risk category of older women is much greater -- not to scare you about your mother.
I would think if your insurance can pay for one of them (Zofran is probably cheaper than the newer ones) its a much better option, unless your doctor has some particular reason to think of drug-drug interactions. Some of these newer drugs are also available in injectible form if your doctor thinks that your mother cannot swallow them.
Hope she feels better.
Tidings
Posted by xbunny on May 18, 2005, at 18:32:22
In reply to Re: Prochlorperazine potency » xbunny, posted by ed_uk on May 18, 2005, at 15:12:51
> I hope you don't mind me asking. What is the cause of her nausea?Its probably the new drug (I dont recall the name) she recently switched to for her arthritus which is getting really severe. Her pain level has gotten to the level where the big codine tablets dont touch it. The gp also gave her omeprazole to take with the prochlorperazine. I just dont like the idea of my generally sane mother taking antipsychotics. The other nite she couldnt sleep cos she kept thinking the power shower was on and kept getting up to check it. Said she felt wired and tired at the same time, which is exactly how I feel on chlorpromazine hence my question about the potency of the prochlorperazine.
Buns
Posted by ed_uk on May 18, 2005, at 19:01:22
In reply to Re: Prochlorperazine potency, posted by xbunny on May 18, 2005, at 18:32:22
Hi Buns!
>Its probably the new drug (I dont recall the name) she recently switched to for her arthritus which is getting really severe.
If she's got rheumatoid arthritis it could be a DMARD such as methotrexate (Maxtrex), leflunomide (Arava) or sulphasalazine (Salazopyrin). On the other hand, it could be an opioid analgesic such as morphine (MST Continus, Zomorph, MXL etc), tramadol (Zydol, Zamadol, Dromadol), dihydrocodeine or oxycodone (OxyContin).
Omeprazole is often used to prevent peptic ulcers caused by NSAIDs such as ibuprofen, diclofenac (Voltarol) and naproxen.
Nausea due to opioid analgesics can be treated with several drugs. Here are some examples......
Cyclizine (Valoid) eg. 50mg three times a day.
Domperidone (Motilium) eg. 10mg three or four times a day.
Nausea due to DMARDs can also be treated with the above drugs.
If the above drugs are not effective, ondansetron (Zofran) or granisetron (Kytril) might be useful. These drugs tend to be quite constipating- have some laxatives ready and waiting!
Dump the prochlorperazine down the toilet! Metoclopramide (Maxolon) is another drug which often causes akathisia, I wouldn't recommend it to your mum.
Kind regards,
Ed.
Posted by ed_uk on May 19, 2005, at 13:21:19
In reply to Re: Prochlorperazine potency, posted by xbunny on May 18, 2005, at 18:32:22
Hi xbunny!
I'm not sure if you saw my post. Anyway, I hope your mum finds a better drug than prochlorperazine! :-)
Kind regards,
Ed.
Posted by xbunny on May 19, 2005, at 14:17:29
In reply to Re: Prochlorperazine potency » xbunny, posted by ed_uk on May 19, 2005, at 13:21:19
Hi Ed,
>
> I'm not sure if you saw my post. Anyway, I hope your mum finds a better drug than prochlorperazine! :-)Thanks for that one, good to know there are plenty of options. Im trying to persuade her to go private so hopefully a private dr will be more modern or at least tell her some options, pros and cons etc
Buns
Posted by ed_uk on May 19, 2005, at 15:32:40
In reply to Re: Prochlorperazine potency, posted by xbunny on May 19, 2005, at 14:17:29
Hi Buns,
A few anti-nausea drugs are available from pharmacies without a prescription. Meclozine (Sea-legs) is sold for motion sickness. Nevertheless, it may be useful in the treatment of many types of nausea and vomiting. Some pharmacies sell cyclizine (Valoid)- but not many. Domperidone (Motilium) is also available without a prescription.
Kind regards,
Ed.PS. I hope you are well. Did you have to reduce your pericyazine dose due to the postural hypotension and dystonias?
Posted by xbunny on May 19, 2005, at 16:40:58
In reply to Re: Prochlorperazine potency » xbunny, posted by ed_uk on May 19, 2005, at 15:32:40
Hi Ed,
I had forgotten about domperidone, my wife takes it sometimes for IBS and swears by it.> PS. I hope you are well. Did you have to reduce your pericyazine dose due to the postural hypotension and dystonias?
Im very well thanks, I hope you are well also. Im still at the same dose. The GP has given me procyclidine for the painful muscles and twitching and the hypotension seems to have passed. Hopefully it was just an adjustment thing. Im not actually sure if I still need the procyclidine I just take one pill in the morning which was when those symptoms were worst. I havent had them since taking it.
Regards Bunny
Posted by ed_uk on May 19, 2005, at 17:40:58
In reply to Re: Prochlorperazine potency, posted by xbunny on May 19, 2005, at 16:40:58
Hi Buns,
>I had forgotten about domperidone, my wife takes it sometimes for IBS and swears by it.
Although you can get it without a prescription, the pack sizes are small and so it works out being very expensive.
>Im very well thanks, I hope you are well also.
I'm glad to hear you're well :-) I'm not too bad at the moment thank you.
>Im not actually sure if I still need the proclyclidine...
Perhaps you could reduce to half a tab?
Kind regards,
Ed.
This is the end of the thread.
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