Bedside Snapshot

Use It For: Severe nausea and vomiting; acute migraine in the ED (IV, AHS 2025 level A, off-label); postoperative nausea; schizophrenia (labeled, rarely the ED choice)
Adult Dose: Nausea: 5–10 mg IM every 3–4 hr, or 2.5–10 mg slow IV (max 10 mg/dose, 40 mg/day)
Migraine: 10 mg IV, often with diphenhydramine 25–50 mg IV
PO 5–10 mg 3–4 times daily; PR 25 mg twice daily
Pediatric Dose: Only ≥2 yr and ≥9 kg. Nausea: 0.13 mg/kg deep IM, usually one dose (NASEMSO caps at 10 mg; label has none), or PO 2.5 mg 1–3×/day or 5 mg 2×/day by weight. Migraine 0.15 mg/kg IV (max 10 mg): off-label, ED protocol only
Onset / Duration: IM: 10–20 min / 3–4 hr (children: up to 12 hr). IV: onset not stated in the label; ED migraine trials judge relief at 60 min. PO: slow, low bioavailability
Do Not Give / Hold If: Phenothiazine allergy; coma, heavy CNS depressants; age <2 yr or <9 kg; unlabeled pediatric use or surgery; marrow depression or past phenothiazine dyscrasia/jaundice (relative); prior akathisia; symptomatic hypotension
Watch For: Akathisia in about 1 in 4 to 1 in 3 after 10 mg IV (restless, wants to leave); dystonia (neck, jaw, eye spasm); hypotension (BP lying down for 30 min); QT risk (ECG if low K⁺/Mg²⁺ or QT drugs)
Reversal / Rescue: No antidote. Akathisia or dystonia: diphenhydramine 25–50 mg IV/IM (child 1 mg/kg, max 50 mg) or benztropine 1–2 mg IV/IM. Hypotension: fluids, norepinephrine or phenylephrine; never epinephrine
Must Remember: Restlessness after the dose is akathisia, not anxiety: stop, treat with diphenhydramine and give no more. Push IV no faster than 5 mg/min, never subcut, and keep the patient lying down

Indications

Emergency & Prehospital

Severe nausea and vomiting: FDA-labeled. Use IM or slow IV when the patient cannot take anything by mouth. Rule out the serious causes first.
Nausea not controlled by ondansetron: it works on a different receptor class. Use it when a 5-HT3 antagonist has failed or is a poor fit.

ED / ICU / Transport

Acute migraine needing parenteral therapy: the American Headache Society (AHS) 2025 ED guideline rates IV prochlorperazine level A (must offer), alongside greater occipital nerve block. IV metoclopramide and ketorolac are level B (off-label).
Pediatric migraine in the ED: an IV dopamine-antagonist option for children 5 years and older. Use it only under an ED or specialist protocol. The US label contraindicates pediatric use where pediatric dosing is not established (off-label).
Postoperative nausea and vomiting: FDA-labeled for adults, given before induction or during and after surgery. Never for pediatric surgery.
Severe nausea and vomiting of pregnancy: the label limits use to intractable vomiting, and only when benefit outweighs risk.

Other Uses

Schizophrenia: FDA-labeled (IM for severe symptoms, then oral). The usual ED choices are haloperidol or olanzapine.
Chemotherapy-related nausea and vomiting: it falls under the labeled severe nausea and vomiting indication. Newer antiemetic regimens are now standard for prevention. Follow the oncology protocol.
Non-psychotic anxiety: tablet label only, for short-term use. It is not a first-line drug.
Vertigo: labeled in the UK for Ménière disease and labyrinthitis. Off-label in the US.

Dosing & Administration

Doses vary by protocol; follow local protocols and medical direction.

Available Forms

Injection 5 mg/mL (prochlorperazine edisylate): 2 mL (10 mg) vial, single- or multiple-dose by maker; the form EMS and EDs carry
Volume check: 2.5 mg = 0.5 mL; 5 mg = 1 mL; 10 mg = 2 mL
Tablets (prochlorperazine maleate): 5 mg and 10 mg
Rectal suppository: 25 mg, labeled for adults only

Adult Dosing

Indication	Dose & Route	Repeat / Max	Notes
Severe nausea and vomiting, IM (FDA-labeled)	5–10 mg deep IM (upper outer buttock)	Repeat every 3–4 hr if needed; max 40 mg/day IM; with IM and IV both used, keep the parenteral total at 40 mg/day or less	Start at the low end; keep the patient lying down and observe at least 30 min
Severe nausea and vomiting, IV (FDA-labeled)	2.5–10 mg slow IV injection or infusion, no faster than 5 mg/min	Max 10 mg per dose; max 40 mg/day IV; with IM and IV both used, keep the parenteral total at 40 mg/day or less	Never a rapid bolus; undiluted or diluted in an isotonic solution
Acute migraine, ED (off-label)	10 mg IV over 2–15 min, often with diphenhydramine 25–50 mg IV	Single dose; max 10 mg per dose, 40 mg/day	AHS 2025 level A. Trials gave it as a 2-min push or 10 mg in 50 mL saline over 15 min
Postoperative nausea and vomiting (FDA-labeled)	5–10 mg IV/IM: IM 1–2 hr or IV 15–30 min before induction, or for symptoms during or after surgery	IM before induction: repeat once in 30 min if needed. IM or IV for symptoms during or after surgery: repeat once if needed. Total parenteral 40 mg/day or less	Adults only; IV no faster than 5 mg/min
Severe nausea and vomiting, PO (FDA-labeled)	5–10 mg PO 3–4 times daily	Above 40 mg/day only in resistant cases	Tablets, once vomiting allows
Severe nausea and vomiting, PR (FDA-labeled)	25 mg PR twice daily	Labeled dose 50 mg/day	Adults only; useful when there is no IV and the patient cannot take oral
Schizophrenia, severe symptoms (FDA-labeled)	10–20 mg deep IM	Repeat every 2–4 hr (resistant cases every hour); more than 3–4 doses seldom needed	Switch to oral once controlled; if parenteral therapy is needed for a prolonged period, 10–20 mg IM every 4–6 hr. Psychiatry-directed

Pediatric Dosing

Indication	Dose (per kg) & Route	Max Single / Max Total	Notes
Severe nausea and vomiting, IM (FDA-labeled; age 2 yr or older and 9 kg or more)	0.13 mg/kg (0.06 mg/lb) deep IM	Usually one dose controls symptoms (label). NASEMSO v3.0 caps the IM dose at 10 mg; the label sets no mg cap	Effect may last up to 12 hr; repeat by the same route only if needed
Severe nausea and vomiting, PO, 20–29 lb (9 to <13.6 kg)	2.5 mg PO 1–2 times daily	Max 7.5 mg/day	More than 1 day of therapy is seldom needed
Severe nausea and vomiting, PO, 30–39 lb (13.6 to <18 kg)	2.5 mg PO 2–3 times daily	Max 10 mg/day	Use the lowest effective dose
Severe nausea and vomiting, PO, 40–85 lb (18–39 kg)	2.5 mg PO 3 times daily or 5 mg PO twice daily	Max 15 mg/day	Use the lowest effective dose
Migraine, ED (off-label; ED or specialist protocol only)	0.15 mg/kg IV	Max 10 mg; single dose	Outside the label, which contraindicates pediatric use where dosing is not established (labeled pediatric routes are deep IM and PO). Evidence is one ED trial in ages 5–18 yr, given with a saline bolus: more effective than ketorolac at 60 min
Schizophrenia (FDA-labeled; psychiatry-directed)	Under 12 yr: 0.13 mg/kg (0.06 mg/lb) deep IM. Ages 2–12 yr: 2.5 mg PO 2–3 times daily to start	IM: control usually with one dose. PO: max 10 mg on day 1; usual max 20 mg/day (2–5 yr) or 25 mg/day (6–12 yr)	After IM control, switch to oral at the same dose or higher; rarely an ED decision
Under 2 yr or under 9 kg, or pediatric surgery	Contraindicated in children under 2 years or under 9 kg (20 lb), in pediatric surgery, and for conditions without established pediatric dosing	—	Use another antiemetic, such as ondansetron, per protocol. See weight-based dosing

Preparation & Administration

Dilution: give it undiluted or diluted in an isotonic solution. Keep other drugs out of the same syringe.
IV rate: no faster than 5 mg/min, so 10 mg takes at least 2 min. Never a rapid bolus. In ED trials, running 10 mg in 50 mL saline over 15 min did not reliably reduce akathisia compared with a 2-min push. One trial found no difference. A second found only a non-significant trend.
IM: go deep into the upper outer quadrant of the buttock. Never subcut, because it causes local irritation.
Positioning: keep the patient lying down and observe at least 30 min after a parenteral dose
Light: keep vials in the carton. Slight yellowing does not change potency. Discard solution that is markedly discolored.
Skin: the solution causes contact dermatitis, so keep it off hands and clothing.

Dosing Notes:

Older, debilitated or emaciated adults: start at the low end of the range. Titrate up slowly.
Children: the US lists no pediatric suppository. The 25 mg suppository is labeled for adults only.
Migraine use is off-label. The 10 mg IV dose comes from ED trials and the AHS guideline. No label covers pediatric IV use at any dose.

Contraindications & Precautions

Contraindications

Known hypersensitivity to phenothiazines
Comatose states, or large amounts of CNS depressants on board (alcohol, barbiturates, opioids)
Children under 2 years or under 9 kg (20 lb), and pediatric surgery
Children, for conditions without established pediatric dosing (label); pediatric dosing is labeled only for severe nausea and vomiting (deep IM, PO) and schizophrenia
Bone marrow depression, or a prior phenothiazine reaction such as a blood dyscrasia or jaundice (relative: only if benefit clearly outweighs risk)

Precautions

Cardiovascular disease or hypovolemia: expect hypotension after parenteral doses. Severe hypotension is reported with mitral insufficiency and pheochromocytoma.
QT risk: UK labeling warns that phenothiazines may make QT prolongation and torsades worse. Use caution with long QT, heart failure, recent MI, HR <50/min, prior ventricular arrhythmia, low K⁺ or Mg²⁺, or other QT drugs.
Seizure disorder: it may lower the seizure threshold.
Parkinson disease: it worsens parkinsonism. The AGS Beers Criteria advise avoiding it.
Glaucoma, urinary retention: anticholinergic effects are the concern.
Possible Reye syndrome or encephalopathy in a child: avoid it. Drug-induced EPS can mimic or mask the CNS signs.
Undiagnosed vomiting: it may mask a bowel obstruction, a brain tumor or an overdose of another drug.

Hold / Reassess If

Symptomatic hypotension after a dose: lie flat or head-low with legs raised, IV fluids; no further doses
Akathisia, dystonia, or restlessness or excitement in a child: stop; no further doses
Deep sedation, SpO₂ <90% or weak airway reflexes, especially with opioids or alcohol
Fever with rigidity and altered mental status (possible NMS): stop all dopamine antagonists
Signs of arrhythmia: stop and obtain a 12-lead ECG

FDA Boxed Warning: Antipsychotics raise the risk of death in older adults with dementia-related psychosis, about 1.6–1.7 times placebo, mostly from cardiovascular or infectious causes. Prochlorperazine carries no approval for dementia-related psychosis.

Adverse Effects & Toxicity

Common

Akathisia: restlessness, anxiety and an urge to leave. In two ED randomized trials, about 26–36% of patients had it within 1 hr of 10 mg IV given without diphenhydramine. Diphenhydramine or benztropine is the usual rescue. The label also lists benzodiazepines or propranolol as options that may help.
Drowsiness and dizziness
Hypotension and postural tachycardia
Anticholinergic effects: dry mouth, blurred vision, constipation, urinary retention
Skin reactions and photosensitivity

Serious / Life-Threatening

Effect	Recognition	Management
Acute dystonia	Neck, jaw, tongue or eye spasm (oculogyric crisis), sometimes throat tightness and trouble breathing; more common in males and younger patients	Diphenhydramine or benztropine; airway support; in children or pregnancy, stop and do not restart
Severe hypotension	BP fall after IV or IM dosing, worse upright or when hypovolemic	Lie flat or head-low with legs raised, IV fluids; norepinephrine or phenylephrine if needed, never epinephrine
Neuroleptic malignant syndrome (rare)	Hyperthermia, rigidity, altered mental status, autonomic instability, rising CK	Stop all antipsychotics, cool, ICU supportive care; no agreed drug regimen, so involve toxicology (e.g. dantrolene)
QT prolongation, torsades	Long QT, R-on-T ectopy, polymorphic VT; risk rises with low K⁺ or Mg²⁺, bradycardia, QT drugs	Stop; correct K⁺ and Mg²⁺; magnesium sulfate; defibrillate if pulseless
Agranulocytosis, leukopenia	Fever, sore throat, infection; may be more frequent in older adults	Stop; CBC; treat infection; ANC <1,000/mm³: discontinue and follow WBC to recovery
Cholestatic jaundice	Fever with flu-like symptoms, then jaundice	Liver tests; stop if abnormal
Tardive dyskinesia	Involuntary tongue, face or jaw movements; risk grows with duration and total dose, rare after brief use	Stop the drug; no proven treatment
Airway compromise, aspiration	Deep sedation, laryngeal dystonia, depressed cough reflex; sudden deaths reported	Position, suction, O₂, BVM; no further sedatives

Overdose & Toxicity Management

Signs: extrapyramidal reactions with dysphagia or breathing difficulty, somnolence to coma, agitation, seizures, ECG changes and arrhythmias, fever, hypotension, ileus
Immediate care: airway, O₂, continuous ECG; ask about co-ingestants; do not induce vomiting (neck dystonia can cause aspiration)
Hypotension: treat it with standard shock measures. If a vasopressor is needed, use norepinephrine or phenylephrine. Epinephrine may lower BP further.
Extrapyramidal symptoms: diphenhydramine 25–50 mg IV/IM (pediatric 1 mg/kg, max 50 mg) or benztropine 1–2 mg IV/IM (not under age 3); avoid deepening respiratory depression
Antidote and removal: there is no antidote, and phenothiazines are not dialyzable. Call poison control (1-800-222-1222).

Monitoring

Parameter	When / How Often	Target / Act If
Clinical: BP and HR	Baseline, then every 5–15 min for at least 30 min after a parenteral dose, patient lying down	Symptomatic hypotension or postural symptoms: lie flat or head-low with legs raised, fluids; hold further doses
Clinical: akathisia and dystonia	During and for at least 1 hr after an IV dose; ask about restlessness before discharge	Restlessness, urge to leave or muscle spasm: diphenhydramine; no more prochlorperazine
Clinical: sedation and airway	Continuous SpO₂ when combined with opioids, alcohol or diphenhydramine	SpO₂ <90% or weak airway reflexes: airway support; stop sedatives
Clinical: symptom response	30–60 min after the dose	Migraine not relieved at 60 min: change class; ongoing vomiting: reassess for obstruction, raised intracranial pressure or toxicity
Clinical: 12-lead ECG	Before dosing when QT risk factors are present	Long QT or arrhythmia: choose another agent
Laboratory: K⁺ and Mg²⁺	Baseline with prolonged vomiting, diuretics or QT risk	Low K⁺ or Mg²⁺: replace before further doses
Laboratory: CBC	Fever or sore throat on therapy; frequent checks early in prolonged therapy if baseline WBC is low	Falling WBC: stop; ANC <1,000/mm³: discontinue and follow to recovery
Clinical: discharge check	Before discharge after a parenteral dose	Still drowsy or restless: keep observing; advise no driving while impaired

Interactions & Compatibility

Clinically Significant Interactions

Drug / Class	Effect	What To Do
CNS depressants (opioids, alcohol, benzodiazepines, barbiturates, anesthetics)	Intensified, prolonged sedation; contraindicated with large amounts on board	Lower doses; monitor SpO₂ and airway
Epinephrine	Alpha-blockade reverses its pressor effect; BP may fall further	For prochlorperazine hypotension use norepinephrine or phenylephrine
QT-prolonging drugs (ondansetron, droperidol, haloperidol, methadone, class IA and III antiarrhythmics)	Higher arrhythmia risk (UK labeling)	Avoid stacking; ECG and electrolytes if combined
Other dopamine antagonists (metoclopramide, droperidol, haloperidol, promethazine)	Additive EPS and NMS risk	Avoid combining; choose a non-dopaminergic antiemetic
Lithium	Encephalopathic syndrome (weakness, fever, confusion, EPS), sometimes permanent brain damage	Monitor closely; stop at the first neurotoxic signs
Anticonvulsants, phenytoin	Lower seizure threshold; possible phenytoin toxicity	Watch seizure control; check phenytoin level
Antihypertensives (thiazide diuretics, propranolol, guanethidine)	Thiazides: additive orthostatic hypotension. Propranolol: higher plasma levels of both drugs. Guanethidine and related drugs: antihypertensive effect may be counteracted	Dose lying down; watch BP, HR and sedation
Oral anticoagulants (warfarin)	Anticoagulant effect may be diminished (label)	Check INR when prochlorperazine is given repeatedly

IV Compatibility

Give it undiluted or diluted in an isotonic solution. ED trials used 50 mL of 0.9% sodium chloride.
Keep other drugs out of the same syringe (label).
Confirm it against an institutional compatibility resource.

Special Populations

Pediatrics: contraindicated under 2 years or under 9 kg, in pediatric surgery, and for conditions without established pediatric dosing. The label covers severe nausea and vomiting (deep IM or PO) and schizophrenia only. Pediatric IV use for migraine sits outside the label. Children with acute illness (chickenpox, CNS infection, measles, gastroenteritis) or dehydration are more prone to dystonia. Use the lowest effective dose. Give no more if restlessness or excitement appears. Doses are in the Pediatric Dosing table.
Pregnancy: safety is not established. The label limits use to severe, intractable nausea and vomiting, and only when benefit outweighs risk. Third-trimester exposure can cause neonatal extrapyramidal or withdrawal signs: agitation, abnormal tone, tremor, respiratory distress and poor feeding. Newborn jaundice and reflex changes are also reported. If EPS occurs in pregnancy, stop and do not restart.
Lactation: phenothiazines pass into breast milk, so use with caution (US label). UK labeling (buccal tablet SmPC) advises against use while breastfeeding.
Older Adults: they are more sensitive to hypotension, confusion, urinary retention, constipation, parkinsonism and tardive dyskinesia. Agranulocytosis may be more frequent too. Start low. The 2023 AGS Beers Criteria advise avoiding antipsychotics except for FDA-approved psychiatric indications (for prochlorperazine, schizophrenia), adjunctive treatment of major depressive disorder, or short-term use as an antiemetic. Keep antiemetic courses short. Beers also advise avoiding it in delirium and in people with a history of falls. It is listed among strong anticholinergic drugs.
Renal Impairment: no specific adjustment is established, and it is not dialyzable. Start at the low end of the range.
Hepatic Impairment: no specific US adjustment is established. The liver metabolizes the drug extensively, and it can cause cholestatic jaundice. Use the lowest effective dose. Some UK products, such as the buccal tablet, contraindicate it in impaired liver function.
Obesity / Dosing Weight: adult doses are fixed. Pediatric doses use actual body weight. NASEMSO caps the IM dose at 10 mg. The label sets no mg cap.
Parkinson Disease: avoid it. It worsens parkinsonism. If drug-induced EPS needs treatment, use an anticholinergic. Levodopa does not work for drug-induced parkinsonism.

Field & Transport Considerations

Scope: Paramedic, RN and critical-care transport can use it for nausea or migraine where protocols include it. Scope varies by state and agency protocol.
Storage & Stability: store at 20–25 °C (68–77 °F). Excursions to 15–30 °C (59–86 °F) are allowed. Protect it from light in the carton. Discard it if markedly discolored.
Carried Concentration: 5 mg/mL, so 10 mg = 2 mL. Say the route out loud: slow IV (max 5 mg/min) or deep IM. Never subcut.
Patient Safety in a Moving Vehicle: dose with the patient lying down and belted. Akathisia can make a patient try to leave the stretcher. Postural hypotension can cause a fall at transfer.
Heat: phenothiazines impair thermoregulation. Limit heat exposure on long scene times or hot transports.
Handoff Essentials: time, dose and route; whether diphenhydramine was given; BP trend; any akathisia or dystonia and the rescue drug; other dopamine antagonists or QT drugs in the past 24 hr.

Clinical Pearls

Exam Discriminator: Akathisia vs Anxiety: Restlessness, pacing or an urge to pull the IV that starts within an hour of IV prochlorperazine? Call it akathisia until you prove otherwise. Another dose only deepens it. Diphenhydramine, then no more doses.

Diphenhydramine Prevents Akathisia Here: Want to stop akathisia before it starts? Add diphenhydramine. In an ED trial, 50 mg IV with prochlorperazine 10 mg IV took akathisia from 36% down to 14%. The price is sedation. So arrange a ride home, and no driving.

No Epinephrine for Its Hypotension: Epinephrine can backfire here, since alpha-blockade can reverse its pressor effect. BP may fall further. Get the patient flat or head-low with legs raised, run fluids, and reach for norepinephrine or phenylephrine if a vasopressor is needed.

Slowing the Push Is Not Reliable Prevention: The assumption is that a slower push means less akathisia. One ED trial ran it over 15 min and got as much akathisia as the 2-min push. A second saw only a non-significant trend toward less. So slow down for the blood pressure, and keep to 5 mg/min. For akathisia, diphenhydramine is what prevents it and rescues it.

Migraine: Where It Fits in the AHS 2025 Guideline:

Level A, must offer: IV prochlorperazine and greater occipital nerve block
Level B, should offer: IV metoclopramide, IV ketorolac, IV dexketoprofen (not US-marketed), subcut sumatriptan, supraorbital nerve block
Level C, may offer: IV chlorpromazine, IV dexamethasone, IV valproate
Level C, should not offer: IV acetaminophen (paracetamol)
Level A, must not offer: IV hydromorphone. IV opioids are not recommended

Dystonia Can Mimic Serious Illness: Neck spasm, oculogyric crisis or tongue protrusion after a dose is a drug reaction. In a vomiting child, that picture can be confused with encephalopathy or Reye syndrome. Treat the dystonia first, then work out why the child is vomiting.

Pharmacology

Mechanism of Action

Dopamine D2 blockade in the chemoreceptor trigger zone gives the antiemetic effect
D2 blockade in mesolimbic pathways gives the antipsychotic effect at higher doses
Nigrostriatal D2 blockade causes akathisia, dystonia, parkinsonism and tardive dyskinesia. Pituitary D2 blockade raises prolactin.
Alpha-adrenergic and muscarinic blockade causes hypotension, postural tachycardia and dry mouth. Antihistamine effects appear with repeated dosing.

Pharmacokinetics

Route	Onset	Peak	Duration
IV	Not stated in the US label; ED trials judge headache relief at 60 min	In volunteers, sedation and psychomotor effects peaked 2–4 hr after peak plasma level; akathisia comes earlier, usually within 1 hr	Not stated in the US label
IM	10–20 min	—	3–4 hr (children: up to 12 hr)
PO	Slow absorption, very low bioavailability	—	Labeled dosing 3–4 times daily
PR	Not stated in the US label	—	Labeled dosing twice daily

Half-life: about 8–9 hr after a single dose (9 hr IV, 8 hr oral). With 14 days of repeated dosing it stretches to about 18 hr, because the drug accumulates.
Metabolism: the drug forms an N-desmethyl metabolite. Low oral bioavailability reflects a large first-pass effect.
Distribution and clearance: the drug spreads widely through the body and clears fast from plasma. Little drug or metabolite shows up in urine.
Elimination: dialysis does not remove it.

Names & Classification

Generic Name: Prochlorperazine edisylate (injection); prochlorperazine maleate (tablets); prochlorperazine (suppository)
Brand Names: Compazine (original US brand; current US injections and tablets are generic); Compro (25 mg suppository)
Pharmacologic Class: Piperazine phenothiazine; dopamine D2 receptor antagonist (first-generation antipsychotic)
Therapeutic Class: Antiemetic; antipsychotic
Controlled Substance: Not controlled
ISMP High-Alert: No
Look-Alike / Sound-Alike: None in the FDA or ISMP tall-man letter tables; the look-alikes listed for chlorpromazine are chlorpropamide and chlordiazepoxide

References

Hikma Pharmaceuticals USA. (2025). Prochlorperazine edisylate injection, USP: Prescribing information (revised January 2025). DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=baf59816-7577-4652-b065-fb6de9e54569
Glenmark Pharmaceuticals. (2026). Prochlorperazine maleate tablets, USP: Prescribing information (DailyMed, updated January 28, 2026). U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9c806152-70d0-43eb-b183-b51b12b82b31
Hikma Pharmaceuticals USA. (2024). Benztropine mesylate injection, USP: Prescribing information (1 mg/mL; DailyMed listing dated April 15, 2024). DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=95620f40-5ddf-41b8-80a5-f658248f26f0
National Association of State EMS Officials. (2022). NASEMSO National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Nausea-Vomiting guideline, p. 90, Patient Safety Considerations 3 (diphenhydramine for dystonia: adult 25–50 mg; child 1 mg/kg, max 50 mg); also prochlorperazine deep IM 0.1 mg/kg, max 10 mg, for age over 2 yr and over 12 kg. https://nasemso.org/docs.ashx?id=1444322
Robblee, J., Minen, M. T., Friedman, B. W., Cortel-LeBlanc, M. A., Cortel-LeBlanc, A., & Orr, S. L. (2026). 2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. Headache, 66(1), 53–76 (published online December 1, 2025). https://doi.org/10.1111/head.70016
Collins, R. W., Jones, J. B., Walthall, J. D., Chisholm, C. D., Giles, B. K., Brizendine, E. J., & Cordell, W. H. (2001). Intravenous administration of prochlorperazine by 15-minute infusion versus 2-minute bolus does not affect the incidence of akathisia: A prospective, randomized, controlled trial. Annals of Emergency Medicine, 38(5), 491–496. https://doi.org/10.1067/mem.2001.119249
Vinson, D. R., & Drotts, D. L. (2001). Diphenhydramine for the prevention of akathisia induced by prochlorperazine: A randomized, controlled trial. Annals of Emergency Medicine, 37(2), 125–131. https://doi.org/10.1067/mem.2001.113032
Isah, A. O., Rawlins, M. D., & Bateman, D. N. (1991). Clinical pharmacology of prochlorperazine in healthy young males. British Journal of Clinical Pharmacology, 32(6), 677–684. https://pubmed.ncbi.nlm.nih.gov/1768559/
Brown & Burk UK. (2025). Prochlorperazine maleate 3 mg buccal tablets: Summary of product characteristics (text revised March 26, 2025). Electronic Medicines Compendium. https://www.medicines.org.uk/emc/product/11729/smpc
Padagis US LLC. (2024). COMPRO- prochlorperazine suppository: Prescribing information (label effective November 20, 2024). DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ea381bc5-0957-4c91-826a-0ff680cebacc
Brousseau, D. C., Duffy, S. J., Anderson, A. C., & Linakis, J. G. (2004). Treatment of pediatric migraine headaches: a randomized, double-blind trial of prochlorperazine versus ketorolac. Annals of Emergency Medicine, 43(2), 256–262. https://doi.org/10.1016/s0196-0644(03)00716-9
2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052–2081. https://doi.org/10.1111/jgs.18372

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