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chlorpromazine hydrochloride

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Overview

What is chlorpromazine hydrochloride?

Chlorpromazine hydrochloride, a dimethylamine derivative of phenothiazine, has a chemical formula of 2-chloro-10-[3(-dimethylamino) propyl] phenothiazine monohydochloride. It is available in tablets for oral administration. It has the following structural formula:

Chlorpromazine hydrochloride occurs as white or slightly creamy white, odorless, crystalline powder which darkens on prolonged exposure to light.

Each tablet for oral administration contains 10 mg, 25 mg, 50 mg, 100 mg, or 200 mg of chlorpromazine HCl, USP. Inactive ingredients: acacia, black iron oxide, calcium sulfate, carnauba wax, D&C Yellow #10 Aluminum Lake, FD&C Blue #2 Aluminum Lake, FD&C Yellow #6 Aluminum Lake, anhydrous lactose, magnesium stearate, methylparaben, pharmaceutical glaze, povidone, propylparaben, sodium benzoate, sucrose and titanium dioxide.



What does chlorpromazine hydrochloride look like?



What are the available doses of chlorpromazine hydrochloride?

Sorry No records found.

What should I talk to my health care provider before I take chlorpromazine hydrochloride?

Sorry No records found

How should I use chlorpromazine hydrochloride?

For the management of manifestations of psychotic disorders. For the treatment of schizophrenia. To control nausea and vomiting. For relief of restlessness and apprehension before surgery. For acute intermittent porphyria. As an adjunct in the treatment of tetanus. To control the manifestations of the manic type of manic-depressive illness. For relief of intractable hiccups.

For the treatment of severe behavioral problems in children (1 to 12 years of age) marked by combativeness and/or explosive hyperexcitable behavior (out of proportion to immediate provocations), and in the short-term treatment of hyperactive children who show excessive motor activity with accompanying conduct disorders consisting of some or all of the following symptoms: impulsivity, difficulty sustaining attention, aggressivity, mood lability and poor frustration tolerance.

Adjust dosage to individual and the severity of his condition, recognizing that the milligram for milligram potency relationship among all dosage forms has not been precisely established clinically. It is important to increase dosage until symptoms are controlled. Dosage should be increased more gradually in debilitated or emaciated patients. In continued therapy, gradually reduce dosage to the lowest effective maintenance level, after symptoms have been controlled for a reasonable period.

The 100 mg and 200 mg tablets are for use in severe neuropsychiatric conditions.


What interacts with chlorpromazine hydrochloride?

Do not use in patients with known hypersensitivity to phenothiazines.


Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).



What are the warnings of chlorpromazine hydrochloride?

Increased Mortality in Elderly Patients with Dementia-Related Psychosis

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Chlorpromazine hydrochloride is not approved for the treatment of patients with dementia-related psychosis (see ).

The extrapyramidal symptoms which can occur secondary to chlorpromazine may be confused with the central nervous system signs of an undiagnosed primary disease responsible for the vomiting, e.g., Reye's syndrome or other encephalopathy. The use of chlorpromazine and other potential hepatotoxins should be avoided in children and adolescents whose signs and symptoms suggest Reye's syndrome.

Tardive Dyskinesia:

Both the risk of developing the syndrome and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase. However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses.

There is no known treatment for established cases of tardive dyskinesia, although the syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn. Antipsychotic treatment itself, however, may suppress (or partially suppress) the signs and symptoms of the syndrome and therapy may possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Given these considerations, antipsychotics should be prescribed in a manner that is most likely to minimize the occurrence of tardive dyskinesia. Chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness that, 1) is known to respond to antipsychotic drugs, and, 2) for whom alternative, equally effective, but potentially less harmful treatments are available or appropriate. In patients who do require chronic treatment, the smallest dose and the shortest duration of treatment producing a satisfactory clinical response should be sought. The need for continued treatment should be reassessed periodically.

If signs and symptoms of tardive dyskinesia appear in a patient on antipsychotics, drug discontinuation should be considered. However, some patients may require treatment despite the presence of the syndrome.

For further information about the description of tardive dyskinesia and its clinical detection, please refer to the sections on and

Neuroleptic Malignant Syndrome (NMS):

The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness (e.g., pneumonia, systemic infection, etc.) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology.

The management of NMS should include 1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, and 3) treatment of any concomitant serious medical problems for which specific treatments are available. There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS.

If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered. The patient should be carefully monitored, since recurrences of NMS have been reported.

An encephalopathic syndrome (characterized by weakness, lethargy, fever, tremulousness and confusion, extrapyramidal symptoms, leukocytosis, elevated serum enzymes, BUN and FBS) has occurred in a few patients treated with lithium plus an antipsychotic. In some instances, the syndrome was followed by irreversible brain damage. Because of a possible causal relationship between these events and the concomitant administration of lithium and antipsychotics, patients receiving such combined therapy should be monitored closely for early evidence of neurologic toxicity and treatment discontinued promptly if such signs appear. This encephalopathic syndrome may be similar to or the same as neuroleptic malignant syndrome (NMS).

Patients with bone marrow depression or who have previously demonstrated a hypersensitivity reaction (e.g., blood dyscrasias, jaundice) with a phenothiazine, should not receive any phenothiazine, including chlorpromazine, unless in the judgment of the physician the potential benefits of treatment outweigh the possible hazard.

Chlorpromazine may impair mental and/or physical abilities, especially during the first few days of therapy. Therefore, caution patients about activities requiring alertness (e.g., operating vehicles or machinery).

The use of alcohol with this drug should be avoided due to possible additive effects and hypotension.

Chlorpromazine may counteract the antihypertensive effect of guanethidine and related compounds.

Usage in Pregnancy:

Reproductive studies in rodents have demonstrated potential for embryotoxicity, increased neonatal mortality and nursing transfer of the drug. Tests in the offspring of the drug–treated rodents demonstrate decreased performance. The possibility of permanent neurological damage cannot be excluded.

Nursing Mothers:


What are the precautions of chlorpromazine hydrochloride?

General

Given the likelihood that some patients exposed chronically to antipsychotics will develop tardive dyskinesia, it is advised that all patients in whom chronic use is contemplated be given, if possible, full information about this risk. The decision to inform patients and/or their guardians must obviously take into account the clinical circumstances and the competency of the patient to understand the information provided.

Chlorpromazine should be administered cautiously to persons with cardiovascular, liver or renal disease. There is evidence that patients with a history of hepatic encephalopathy due to cirrhosis have increased sensitivity to the CNS effects of chlorpromazine (i.e., impaired cerebration and abnormal slowing of the EEG).

Because of its CNS depressant effect, chlorpromazine should be used with caution in patients with chronic respiratory disorders such as severe asthma, emphysema and acute respiratory infections, particularly in children (1 to 12 years of age).

Because chlorpromazine can suppress the cough reflex, aspiration of vomitus is possible.

Chlorpromazine prolongs and intensifies the action of CNS depressants such as anesthetics, barbiturates and narcotics. When chlorpromazine is administered concomitantly, about ¼ to ½ the usual dosage of such agents is required. When chlorpromazine is not being administered to reduce requirements of CNS depressants, it is best to stop such depressants before starting chlorpromazine treatment. These agents may subsequently be reinstated at low doses and increased as needed.

Note:

not

not

Use with caution in persons who will be exposed to extreme heat, organophosphorus insecticides, and in persons receiving atropine or related drugs.

Antipsychotic drugs elevate prolactin levels; the elevation persists during chronic administration. Tissue culture experiments indicate that approximately 1/3 of human breast cancers are prolactin-dependent a factor of potential importance if the prescribing of these drugs is contemplated in a patient with a previously detected breast cancer. Although disturbances such as galactorrhea, amenorrhea, gynecomastia and impotence have been reported, the clinical significance of elevated serum prolactin levels is unknown for most patients. An increase in mammary neoplasms has been found in rodents after chronic administration of antipsychotic drugs. Neither clinical nor epidemiologic studies conducted to date, however, have shown an association between chronic administration of these drugs and mammary tumorigenesis; the available evidence is considered too limited to be conclusive at this time.

Chromosomal aberrations in spermatocytes and abnormal sperm have been demonstrated in rodents treated with certain antipsychotics.

As with all drugs which exert an anticholinergic effect, and/or cause mydriasis, chlorpromazine should be used with caution in patients with glaucoma.

Chlorpromazine diminishes the effect of oral anticoagulants.

Phenothiazines can produce alpha-adrenergic blockade. Chlorpromazine may lower the convulsive threshold; dosage adjustments of anticonvulsants may be necessary. Potentiation of anticonvulsant effects does not occur. However, it has been reported that chlorpromazine may interfere with the metabolism of phenytoin and thus precipitate phenytoin toxicity.

Concomitant administration with propranolol results in increased plasma levels of both drugs.

Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines.

The presence of phenothiazines may produce false-positive phenylketonuria (PKU) test results.

Drugs which lower the seizure threshold, including phenothiazine derivatives, should not be used with metrizamide. As with other phenothiazine derivatives, chlorpromazine should be discontinued at least 48 hours before myelography, should not be resumed for at least 24 hours post-procedure, and should not be used for the control of nausea and vomiting occurring either prior to myelography or postprocedure with metrizamide.

Long-Term Therapy:

Antiemetic Effect:

When chlorpromazine is used with cancer chemotherapeutic drugs, vomiting as a sign of the toxicity of these agents may be obscured by the antiemetic effect of chlorpromazine.

Abrupt Withdrawal:


What are the side effects of chlorpromazine hydrochloride?

Note:

Drowsiness:

Jaundice:

There is no conclusive evidence that preexisting liver disease makes patients more susceptible to jaundice. Alcoholics with cirrhosis have been successfully treated with chlorpromazine without complications. Nevertheless, the medication should be used cautiously in patients with liverdisease. Patients who have experienced jaundice with a phenothiazine should not, if possible, be reexposed to chlorpromazine or other phenothiazines.

If fever with grippe-like symptoms occurs, appropriate liver studies should be conducted. If tests indicate an abnormality, stop treatment.

Liver function tests in jaundice induced by the drug may mimic extrahepatic obstruction; withhold exploratory laparotomy until extrahepatic obstruction is confirmed.

Hematological Disorders,

Agranulocytosis

Most cases have occurred between the fourth and tenth weeks of therapy; patients should be watched closely during that period.

Moderate suppression of white blood cells is not an indication for stopping treatment unless accompanied by the symptoms described above.

Cardiovascular:

Hypotensive Effects –

To control hypotension, place patient in head–low position with legs raised. If a vasoconstrictor is required, norepinephrine and phenylephrine are the most suitable. Other pressor agents, including epinephrine, should not be used as they may cause a paradoxical further lowering of blood pressure.

EKG Changes

Note:

CNS Reactions:

Extrapyramidal Symptoms

Dystonia:

Class effect

Motor Restlessness:

If these symptoms become too troublesome, they can usually be controlled by a reduction of dosage or change of drug. Treatment with anti–parkinsonian agents, benzodiazepines or propranolol may be helpful.

Pseudo – parkinsonism:

Note:

Tardive Dyskinesia:

There is no known effective treatment for tardive dyskinesia; anti-parkinsonism agents do not alleviate the symptoms of this syndrome. If clinically feasible, it is suggested that all antipsychotic agents be discontinued, if these symptoms appear. Should it be necessary to reinstitute treatment, or increase the dosage of the agent, or switch to a different antipsychotic agent, the syndrome may be masked.

It has been reported that fine vermicular movements of the tongue may be an early sign of the syndrome and if the medication is stopped at that time the syndrome may not develop.

Adverse Behavioral Effects

Other CNS Effects

Cerebral edema has been reported.

Convulsive seizures (petit mal and grand mal) have been reported, particularly in patients with EEG abnormalities or history of such disorders.

Abnormality of the cerebrospinal fluid proteins has also been reported.

Allergic reactions

Contact dermatitis has been reported in nursing personnel; accordingly, the use of rubber gloves when administering chlorpromazine liquid or injectable is recommended.

In addition, asthma, laryngeal edema, angioneurotic edema and anaphylactoid reactions have been reported.

Endocrine Disorders:

Autonomic Reactions

Special Considerations In Long-Term Therapy:

Skin Pigmentation

The pigmentary changes, restricted to exposed areas of the body, range from an almost imperceptible darkening of the skin to a slate gray color, sometimes with a violet hue. Histological examination reveals a pigment, chiefly in the dermis, which is probably a melanin-like complex. This pigmentation may fade following discontinuance of the drug.

Ocular Changes

Since the occurrence of eye changes seems to be related to dosage levels and/or duration of therapy, it is suggested that long-term patients on moderate to high dosage levels have periodic ocular examinations.

Etiology

Other Adverse Reactions:

Note:


What should I look out for while using chlorpromazine hydrochloride?

Do not use in patients with known hypersensitivity to phenothiazines.

Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).


What might happen if I take too much chlorpromazine hydrochloride?

(See also .)


How should I store and handle chlorpromazine hydrochloride?

Store at 20°-25°C (68°-77°F) (see USP Controlled Room Temperature). Protect from light.Dispense in a tight, light-resistant container.Store at 20°-25°C (68°-77°F) (see USP Controlled Room Temperature). Protect from light.Dispense in a tight, light-resistant container. Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy Chlorpromazine HCl Tablets, USP, 10 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "10" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 25 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "25" and no print on the reverse side. Chlorpromazine HCl Tablets, USP, 50 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "50" and no print on the reverse side. THESE TABLET STRENGTHS LISTED BELOW ARE FOR USE ONLY IN SEVERE NEUROPSYCHIATRIC CONDITIONS.Chlorpromazine HCl Tablets, USP, 100 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "100" and no print on the reverse side.. Chlorpromazine HCl Tablets, USP, 200 mg are round, butterscotch-colored, sugar coated tablets, imprinted on one side with "832" above the "200" and no print on the reverse side.They are supplied by as follows: Store at controlled room temperature 20 – 25° C (68 – 77° F). Excursions permitted to 15 - 30° (59 - 86° F). [See USP Controlled Room Temperature.] Protect from light and moisture. This package is not for household dispensing. Dispense in a well closed, light-resistant container as defined in the USP. Keep out of reach of children. Rx only Manufactured by:UPSHER-SMITH LABORATORIES, INC.Minneapolis, MN 55447This Product was Repackaged By:State of Florida DOH Central Pharmacy


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Non-Clinical Toxicology
Do not use in patients with known hypersensitivity to phenothiazines.

Do not use in comatose states or in the presence of large amounts of central nervous system depressants (alcohol, barbiturates, narcotics, etc.).

Clonidine may potentiate the CNS-depressive effects of alcohol, barbiturates or other sedating drugs. If a patient receiving clonidine hydrochloride is also taking tricyclic antidepressants, the hypotensive effect of clonidine may be reduced, necessitating an increase in the clonidine dose.

Due to a potential for additive effects such as bradycardia and AV block, caution is warranted in patients receiving clonidine concomitantly with agents known to affect sinus node function or AV nodal conduction, e.g., digitalis, calcium channel blockers and beta-blockers.

Amitriptyline in combination with clonidine enhances the manifestation of corneal lesions in rats (see ).

Serious adverse events, including death, have been reported in concomitant use with methylphenidate in patients with underlying cardiovascular conditions, although no association for the combination has been established. The safety of using clonidine in combination with methylphenidate has not been systematically evaluated.

Given the likelihood that some patients exposed chronically to antipsychotics will develop tardive dyskinesia, it is advised that all patients in whom chronic use is contemplated be given, if possible, full information about this risk. The decision to inform patients and/or their guardians must obviously take into account the clinical circumstances and the competency of the patient to understand the information provided.

Chlorpromazine should be administered cautiously to persons with cardiovascular, liver or renal disease. There is evidence that patients with a history of hepatic encephalopathy due to cirrhosis have increased sensitivity to the CNS effects of chlorpromazine (i.e., impaired cerebration and abnormal slowing of the EEG).

Because of its CNS depressant effect, chlorpromazine should be used with caution in patients with chronic respiratory disorders such as severe asthma, emphysema and acute respiratory infections, particularly in children (1 to 12 years of age).

Because chlorpromazine can suppress the cough reflex, aspiration of vomitus is possible.

Chlorpromazine prolongs and intensifies the action of CNS depressants such as anesthetics, barbiturates and narcotics. When chlorpromazine is administered concomitantly, about ¼ to ½ the usual dosage of such agents is required. When chlorpromazine is not being administered to reduce requirements of CNS depressants, it is best to stop such depressants before starting chlorpromazine treatment. These agents may subsequently be reinstated at low doses and increased as needed.

Note:

not

not

Use with caution in persons who will be exposed to extreme heat, organophosphorus insecticides, and in persons receiving atropine or related drugs.

Antipsychotic drugs elevate prolactin levels; the elevation persists during chronic administration. Tissue culture experiments indicate that approximately 1/3 of human breast cancers are prolactin-dependent a factor of potential importance if the prescribing of these drugs is contemplated in a patient with a previously detected breast cancer. Although disturbances such as galactorrhea, amenorrhea, gynecomastia and impotence have been reported, the clinical significance of elevated serum prolactin levels is unknown for most patients. An increase in mammary neoplasms has been found in rodents after chronic administration of antipsychotic drugs. Neither clinical nor epidemiologic studies conducted to date, however, have shown an association between chronic administration of these drugs and mammary tumorigenesis; the available evidence is considered too limited to be conclusive at this time.

Chromosomal aberrations in spermatocytes and abnormal sperm have been demonstrated in rodents treated with certain antipsychotics.

As with all drugs which exert an anticholinergic effect, and/or cause mydriasis, chlorpromazine should be used with caution in patients with glaucoma.

Chlorpromazine diminishes the effect of oral anticoagulants.

Phenothiazines can produce alpha-adrenergic blockade. Chlorpromazine may lower the convulsive threshold; dosage adjustments of anticonvulsants may be necessary. Potentiation of anticonvulsant effects does not occur. However, it has been reported that chlorpromazine may interfere with the metabolism of phenytoin and thus precipitate phenytoin toxicity.

Concomitant administration with propranolol results in increased plasma levels of both drugs.

Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines.

The presence of phenothiazines may produce false-positive phenylketonuria (PKU) test results.

Drugs which lower the seizure threshold, including phenothiazine derivatives, should not be used with metrizamide. As with other phenothiazine derivatives, chlorpromazine should be discontinued at least 48 hours before myelography, should not be resumed for at least 24 hours post-procedure, and should not be used for the control of nausea and vomiting occurring either prior to myelography or postprocedure with metrizamide.

Note:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Tips

Tips

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Interactions

Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).