chlorpromazine

Adult Dosing .

Dosage forms:  TAB: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg; SOL: 30 mg per mL, 100 mg per mL; INJ: 25 mg per mL

psychosis

[mild-moderate sx]

Dose: 200-400 mg/day PO divided tid-qid; Start: 10-25 mg PO tid; may incr. by 20-50 mg/day after 1-2 days, then q3-4 days; Max: 1000 mg/day; Info: start lower/titrate slower in elderly pts; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[severe sx, non-hospitalized]

Dose: 200-600 mg/day PO divided tid-qid; Start: 25 mg IM x1, may repeat in 1h, then 25-50 mg PO tid; may incr. by 20-50 mg/day after 1-2 days, then q3-4 days; Max: 1000 mg/day; Info: start lower/titrate slower in elderly pts; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[severe sx, hospitalized]

Dose: 200-800 mg/day PO divided tid-qid; Start: 25 mg IM x1, may repeat w/ 25-50 mg in 1h; incr. IM dose gradually over several days until sx controlled, then switch to PO; Max: 400 mg IM q4h; 2000 mg/day PO; Info: start lower/titrate slower in elderly pts; PO doses >1000 mg/day rarely more effective, may incr. ADR risk; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

nausea/vomiting

[10-25 mg PO q4-6h prn]

Alt: 25 mg IM x1, then 25-50 mg IM q3-4h prn; Info: switch to PO ASAP if IM started; D/C or decr. dose if hypotension occurs; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

nausea/vomiting, intraop

[12.5 mg IM q30min prn]

Max: 25 mg IV; Alt: 2 mg IV over 2min q2-5min prn; Info: may prolong/intensify anesthesia effects; D/C or decr. dose if hypotension occurs; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

sedation, preop

[25-50 mg PO x1]

Alt: 12.5-25 mg IM x1; Info: give PO dose 2-3h preop, IM dose 1-2h preop; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

hiccups, intractable

[25-50 mg PO tid-qid]

Start: 25 mg PO tid; Alt: 25-50 mg IM/IV x1 if no response to PO tx after 2-3 days; Info: D/C if ANC <1000; consider D/C if unexplained decr. in WBC

tetanus, adjunct tx

[25-50 mg IM/IV q6-8h]

Info: IM preferred over IV; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

porphyria, acute intermittent

[25-50 mg PO tid-qid]

Alt: 25 mg IM tid-qid; Info: D/C if ANC <1000; consider D/C if unexplained decr. in WBC

serotonin syndrome, adjunct tx (off-label)

[12.5-50 mg IM/IV q4-8h PRN]

Info: D/C if ANC <1000; consider D/C if unexplained decr. in WBC

nausea/vomiting, migraine-assoc. (off-label)

[12.5-25 mg IV x1]

Alt: 0.1 mg/kg/dose IV q15min up to 3 doses; Info: D/C if ANC <1000; consider D/C if unexplained decr. in WBC

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  TAB: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg; SOL: 30 mg per mL, 100 mg per mL; INJ: 25 mg per mL

behavioral disorders, severe

[6 mo-5 yo]

Dose: 2.5-6 mg/kg/day PO divided q4-6h; Max: 50 mg/day PO, 40 mg/day IM; Alt: 2.5-4 mg/kg/day IM divided q6-8h; Info: for behavioral problems related to psychosis or developmental disorders; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[5-12 yo]

Dose: 2.5-6 mg/kg/day PO divided q4-6h; Max: 200 mg/day PO, 75 mg/day IM; Alt: 2.5-4 mg/kg/day IM divided q6-8h; Info: for behavioral problems related to psychosis or developmental disorders; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[>12 yo]

see Adult Dosing

nausea/vomiting

[6 mo-5 yo]

Dose: 0.55 mg/kg/dose IM q6-8h prn; Max: 40 mg/day IM; Alt: 0.55 mg/kg/dose PO q4-6h prn; Info: D/C or decr. dose if hypotension occurs; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[5-12 yo]

Dose: 0.55 mg/kg/dose IM q6-8h prn; Max: 75 mg/day IM: Alt: 0.55 mg/kg/dose PO q4-6h prn; Info: D/C or decr. dose if hypotension occurs; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[>12 yo]

see Adult Dosing

nausea/vomiting, intraop

[6 mo-12 yo]

Dose: 0.25 mg/kg/dose IM q30min prn; Alt: 1 mg IV q2-5min prn; Info: may prolong/intensify anesthesia effects; D/C or decr. dose if hypotension occurs; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[>12 yo]

see Adult Dosing

sedation, preop

[6 mo-12 yo]

Dose: 0.5 mg/kg/dose IM/PO x1; Info: give PO dose 2-3h preop, IM dose 1-2h preop; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[>12 yo]

see Adult Dosing

tetanus, adjunct tx

[6 mo-5 yo]

Dose: 0.5 mg/kg/dose IM/IV q6-8h prn; Max: 40 mg/day IM; Info: IM preferred over IV; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[5-12 yo]

Dose: 0.5 mg/kg/dose IM/IV q6-8h prn; Max: 75 mg/day IM; Info: IM preferred over IV; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[>12 yo]

see Adult Dosing

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised