[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Dopamine-antagonist antiemetics and prokinetics](https://durgical.com/en/pharmacology/classes/dopamine-antagonist-antiemetics-and-prokinetics/) › Prochlorperazine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Dopamine-antagonist antiemetics and prokinetics](https://durgical.com/en/pharmacology/classes/dopamine-antagonist-antiemetics-and-prokinetics/)

# Prochlorperazine

A phenothiazine that blocks dopamine in the vomiting centre. It controls severe nausea but can cause dystonia, low blood pressure and sedation.

Updated 2026-11-01

- Class: [Dopamine-antagonist antiemetics and prokinetics](https://durgical.com/en/pharmacology/classes/dopamine-antagonist-antiemetics-and-prokinetics/)
- Receptor: Dopamine D2 receptor
- ATC code: N05AB04

◎**Dopamine D2 receptor**Prochlorperazine

ⓘ No structure of prochlorperazine bound to D2 exists; the figure shows haloperidol, another antipsychotic, in the same dopamine pocket of the human D2 receptor.

**Target in 3D:** Dopamine D2 receptor. PDB structure 6LUQ (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6LUQ) · Drag to rotate · pinch to zoom

## Mechanism of action

Prochlorperazine is a piperazine phenothiazine. Like the other phenothiazines it blocks dopamine D2 receptors in the chemoreceptor trigger zone, which depresses the vomiting reflex, and it also has an antipsychotic effect. It blocks α-adrenergic receptors and has anticholinergic effects, which explain low blood pressure, blurred vision and dry mouth.

- Blocks D2 receptors in the chemoreceptor trigger zone
- The vomiting reflex is depressed: less nausea
- α1 block and anticholinergic effects add hypotension and dry mouth
- D2 block in the basal ganglia causes dystonia and akathisia

## Pharmacokinetics

**Absorption**
Given by mouth (tablets), rectally (suppositories), intramuscularly or intravenously.

**Onset and duration**
After an intramuscular dose it acts within 10–20 minutes and lasts about 3–4 hours.

## Indications

- Control of severe nausea and vomiting.
- Schizophrenia. [Schizophrenia →](https://durgical.com/en/conditions/schizophrenia/)

## Adverse effects

### Common

- Drowsiness and dizziness
- Low blood pressure, especially after injection
- Blurred vision and dry mouth
- Amenorrhoea and skin reactions

### Serious (rare, important)

- Acute dystonia, akathisia and parkinsonism
- Tardive dyskinesia with long-term use
- Neuroleptic malignant syndrome
- Leukopenia, neutropenia and agranulocytosis; cholestatic jaundice
- Higher mortality in older adults with dementia-related psychosis (boxed warning)
- Lower seizure threshold

## Contraindications

- Hypersensitivity to phenothiazines
- Coma or large amounts of CNS depressants (alcohol, barbiturates, opioids)
- Children under 2 years or under the weight set in the label
- Bone marrow depression or a prior blood dyscrasia or jaundice from a phenothiazine (unless benefit clearly outweighs risk)

## Key interactions

**Alcohol, anaesthetics, opioids and other CNS depressants**
Deeper and longer sedation.

**Epinephrine**
Phenothiazines block α receptors, so epinephrine can lower blood pressure further; norepinephrine or phenylephrine are used if a vasopressor is needed.

**Thiazide diuretics and antihypertensives**
More orthostatic hypotension.

**Propranolol**
Higher levels of both drugs.

**Anticonvulsants and phenytoin**
Lower seizure threshold, and phenytoin toxicity reported.

**Lithium**
Rare encephalopathic syndrome with antipsychotics.

## What is monitored

- Blood pressure lying and standing, especially after injection
- Abnormal movements (dystonia, akathisia, tardive dyskinesia)
- Complete blood count in patients with low white cells or prior drug-induced neutropenia
- Temperature and muscle rigidity (neuroleptic malignant syndrome)

## Administration and safety

- Not given subcutaneously, because it irritates the tissue
- After an injection the patient stays lying down and is observed for at least half an hour because of hypotension
- Staff avoid skin contact with the solution, which can cause contact dermatitis
- Its antiemetic effect can mask intestinal obstruction, brain tumour or overdose of other drugs

## Nursing care

- Check blood pressure before and after an injection and help the patient up slowly
- Watch for twisted neck, jaw spasm, restlessness or eye deviation after the dose
- Warn about drowsiness and falls, especially in older adults
- Ask about alcohol and other sedatives
- Teach the patient to report fever, sore throat or yellow skin

## Pregnancy and breastfeeding

Newborns whose mothers received phenothiazines have shown prolonged jaundice and extrapyramidal signs; it is used only when clearly needed.

## Memory aid

«PROCHLORPERAZINE = PRO-CHLOR-PROBLEMS»: a phenothiazine that stops vomiting but brings the antipsychotic package: dystonia, hypotension and sedation.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is epinephrine avoided to treat hypotension caused by prochlorperazine?

Phenothiazines block α receptors, so epinephrine's β2 vasodilation predominates and blood pressure can fall further; norepinephrine or phenylephrine are used instead.

## Why does a patient stay lying down after an intramuscular dose of prochlorperazine?

It can cause hypotension through α1-adrenergic block; the patient is observed for at least half an hour.

## Which receptor explains prochlorperazine's antiemetic effect?

The dopamine D2 receptor in the chemoreceptor trigger zone.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/prochlorperazine/)

## Related drugs

- [Metoclopramide](https://durgical.com/en/pharmacology/metoclopramide/)
- [Chlorpromazine](https://durgical.com/en/pharmacology/chlorpromazine/)
- [Haloperidol](https://durgical.com/en/pharmacology/haloperidol/)

## Related conditions

- [Schizophrenia](https://durgical.com/en/conditions/schizophrenia/)

[← Back to the class: Dopamine-antagonist antiemetics and prokinetics](https://durgical.com/en/pharmacology/classes/dopamine-antagonist-antiemetics-and-prokinetics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - PROCHLORPERAZINE EDISYLATE injection](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e3e0c6c5-6b92-40e0-a926-29c64846be93) (DailyMed (U.S. National Library of Medicine), 2026); [Prochlorperazine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a682116.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [RCSB PDB - 6LUQ: Haloperidol bound D2 dopamine receptor structure inspired discovery of subtype selective ligands](https://www.rcsb.org/structure/6LUQ) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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