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Antiemetic (Phenothiazine — Dopamine D₂ Antagonist)

Prochlorperazine

Brand names: Stemetil, Buccastem M

Prochlorperazine is a phenothiazine antiemetic used for nausea and vomiting, including that associated with vestibular disorders and migraine.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It antagonises dopamine D2 receptors in the chemoreceptor trigger zone, suppressing the emetic reflex; its antidopaminergic action also underlies its extrapyramidal effects.

Prescribing in practice

  • It can cause acute dystonic reactions, particularly in young adults, children and the elderly, and other extrapyramidal effects, so it should be used with caution and avoided where these risks are high.
  • It lowers the seizure threshold and can prolong the QT interval, warranting caution with other QT-prolonging or epileptogenic drugs and in cardiac disease.
  • Use cautiously in the elderly, who are more prone to postural hypotension, sedation and extrapyramidal effects.

Monitoring

Monitor clinically for extrapyramidal and dystonic reactions and for postural hypotension, especially in older patients.

Counselling the patient

  • It may cause drowsiness that can affect driving and use of machinery.
  • Seek urgent help for involuntary muscle spasms of the face, neck or eyes.
  • Rise slowly from sitting or lying to reduce dizziness.

Evidence & guidelines

Prochlorperazine is a long-established antiemetic with efficacy supported by extensive clinical use and prescribing references.

Reference: NICE NG121 Nausea and Vomiting in Pregnancy; SPC Stemetil; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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