intramuscular injection: 40 – 50 mg of chlorpromazine
base or hydrochloride givenby mouth.lCONTRA-INDICATIONSCNS depression.comatose states.
hypothyroidism.phaeochromocytoma
lINTERACTIONS→Appendix 1 : phenothiazines
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Common or very commonAnxiety.glucose tolerance
impaired.mood altered.muscle tone increased.postural
hypotension
▶Frequency not knownAccommodation disorder.
angioedema.atrioventricular block.cardiac arrest.eye
deposit.eye disorders.gastrointestinal disorders.hepatic
disorders.hypertriglyceridaemia.hyponatraemia.
photosensitivity reaction.respiratory disorders.SIADH.
skin reactions.systemic lupus erythematosus (SLE).
temperature regulation disorder.trismus
SPECIFIC SIDE-EFFECTS
▶With intramuscular useMuscle rigidity.nasal congestion
SIDE-EFFECTS, FURTHER INFORMATIONAcute dystonic
reactions may occur, children are particularly susceptible.lHEPATIC IMPAIRMENTCan precipitate coma;
phenothiazines are hepatotoxic.
lRENAL IMPAIRMENT
Dose adjustmentsStart with small doses in severe renal
impairment because of increased cerebral sensitivity.
lMONITORING REQUIREMENTS
▶With intramuscular usePatients should remain supine, with
blood pressure monitoring for 30 minutes after
intramuscular injection.
lHANDLING AND STORAGEOwing to the risk of contact
sensitisation, pharmacists, nurses, and other health
workers should avoid direct contact with chlorpromazine;
tablets should not be crushed and solutions should be
handled with care.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet, capsule, oral suspension, oral
solution
Tablet
CAUTIONARY AND ADVISORY LABELS2, 11
▶Chlorpromazine hydrochloride (Non-proprietary)
Chlorpromazine hydrochloride 25 mgChlorpromazine 25 mg
tablets| 28 tabletP£ 42. 00 DT = £ 37. 13
Chlorpromazine hydrochloride 50 mgChlorpromazine 50 mg
tablets| 28 tabletP£ 42. 00 DT = £ 28. 09
Chlorpromazine hydrochloride 100 mgChlorpromazine 100 mg
tablets| 28 tabletP£ 42. 00 DT = £ 37. 51
Solution for injection
▶Largactil(Sanofi)
Chlorpromazine hydrochloride 25 mg per 1 mlLargactil 50 mg/ 2 ml
solution for injection ampoules| 10 ampouleP£ 7. 51
Oral solution
CAUTIONARY AND ADVISORY LABELS2, 11
▶Chlorpromazine hydrochloride (Non-proprietary)
Chlorpromazine hydrochloride 5 mg per 1 mlChlorpromazine
25 mg/ 5 ml syrup| 150 mlP£ 2. 35 DT = £ 2. 35
Chlorpromazine 25 mg/ 5 ml oral solution sugar free sugar-free|
150 mlP£ 2. 35 DT = £ 2. 35
Chlorpromazine 25 mg/ 5 ml oral solution| 150 mlP£ 2. 35 DT =
£ 2. 35
Chlorpromazine hydrochloride 20 mg per 1 mlChlorpromazine
100 mg/ 5 ml oral solution| 150 mlP£ 5. 50 DT = £ 5. 50
eiiiiF 244Haloperidol 18-May-2018
lINDICATIONS AND DOSE
Schizophrenia (under expert supervision)
▶BY MOUTH
▶Child 3–12 years:Initially 500 micrograms daily in
2 – 3 divided doses; usual dose 1 – 4 mg daily in
2 – 3 divided doses, daily maximum to be given in
2 – 3 divided doses; maximum 6 mg per day
▶Child 13–17 years:Initially 500 micrograms daily in
2 – 3 divided doses; usual dose 1 – 6 mg daily in
2 – 3 divided doses, daily maximum to be given in
2 – 3 divided doses; maximum 10 mg per day
Childhood behavioural disorders, especially when
associated with hyperactivity and aggression (under
expert supervision)|Gilles de la Tourette syndrome
(under expert supervision)
▶BY MOUTH
▶Child 3–12 years:Initially 250 micrograms daily in
2 – 3 divided doses; usual dose 0. 5 – 3 mg daily in
2 – 3 divided doses, daily maximum to be given in
2 – 3 divided doses; maximum 3 mg per day
▶Child 13–17 years:Initially 250 micrograms daily in
2 – 3 divided doses; usual dose 2 – 6 mg daily in
2 – 3 divided doses, daily maximum to be given in
2 – 3 divided doses; maximum 6 mg per day
Nausea and vomiting in palliative care
▶BY MOUTH
▶Child 12–17 years: 1. 5 mg once daily, dose to be taken at
night, increased if necessary to 1. 5 mg twice daily
(max. per dose 5 mg twice daily)
▶BY CONTINUOUS INTRAVENOUS INFUSION, OR BY CONTINUOUS
SUBCUTANEOUS INFUSION
▶Child 1 month–11 years: 25 – 85 micrograms/kg, to be
administered over 24 hours
▶Child 12–17 years: 1. 5 – 5 mg, to be administered over
24 hours
Restlessness and confusion in palliative care
▶BY MOUTH
▶Child 1–17 years: 10 – 20 micrograms/kg every
8 – 12 hourslUNLICENSED USENot licensed for use in children for
nausea and vomiting in palliative care.
lCONTRA-INDICATIONSCNS depression.comatose states.
congenital long QT syndrome.history of torsade de
pointes.history of ventricular arrhythmia.QTc-interval
prolongation.recent acute myocardial infarction.
uncompensated heart failure.uncorrected hypokalaemia
lCAUTIONSBradycardia.electrolyte disturbances (correct
before treatment initiation).family history of QTc-
interval prolongation.history of heavy alcohol exposure.
hyperthyroidism.hypotension (including orthostatic
hypotension).prolactin-dependent tumours.
prolactinaemia
lINTERACTIONS→Appendix 1 : haloperidol
lSIDE-EFFECTS
▶Common or very commonDepression.eye disorders.
headache.hypersalivation.nausea.neuromuscular
dysfunction.postural hypotension.psychotic disorder.
vision disorders.vomiting.weight decreased
▶UncommonBreast abnormalities.dyspnoea.gait
abnormal.hepatic disorders.hyperhidrosis.menstrual
cycle irregularities.muscle complaints.musculoskeletal
stiffness.oedema.photosensitivity reaction.restlessness
.sedation.skin reactions.temperature regulation
disordersBNFC 2018 – 2019 Psychoses and schizophrenia 245
Nervous system4