Table 27

Prochlorperazine buccal

Prochlorperazine buccal
What is it?Anti-emetic
Mechanism of actionAntagonist to: D2, 5HT (2A and 2C), H1 and α1, and muscarinic receptors
Starting dose3mg to 6mg every 12 hours17
Time to maximal effect8 hours (4 hours with regular dosing)
Formulation3 mg orodispersible tablets (Buccastem)
IndicationDizziness, nausea
Common adverse effects‘Agitation; amenorrhoea; arrhythmias; constipation; dizziness; drowsiness; dry mouth; erectile dysfunction; galactorrhoea; gynaecomastia; hyperprolactinaemia; hypotension (dose-related); insomnia; leucopenia; movement disorders; neutropenia; parkinsonism; QT interval prolongation; rash; seizure; tremor; urinary retention; vomiting; weight increased’16
Contraindications‘Central nervous system depression; comatose states; phaeochromocytoma”16
LicencingLicensed formulation
BenefitsBuccal alternative anti-emetic, widely used in clinical practice
RisksOral and skin reactions possible, constipating
Cost£27.61 for 50×3 mg buccal tablets