Medication Fact Sheets
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May 5, 2025

Prochlorperazine Maleate: Uses, Side Effects, and Dosage

Medically Reviewed by
Updated On
May 27, 2025

Imagine a world where debilitating nausea and vertigo no longer control your life. For many people, symptoms like dizziness, vomiting, and even migraine-related discomfort can be overwhelming and interfere with daily activities.

Prochlorperazine maleate is a well-established medication that relieves several of these conditions. It belongs to a group of drugs known as phenothiazines and is often used when other treatments fail. This comprehensive guide explores prochlorperazine maleate, how it works, its safe use, and potential side effects.

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Understanding Prochlorperazine Maleate

Understanding how prochlorperazine functions in the body and why it is prescribed can help one better appreciate its role.

What is Prochlorperazine Maleate?

Prochlorperazine maleate is a prescription medication primarily used to control severe nausea and vomiting. It is also effective in treating dizziness, vertigo, and, in some cases, migraines. It has been in clinical use for decades and is available in several forms, including oral tablets, rectal suppositories, and injectable solutions.

How Prochlorperazine Works in the Body

Prochlorperazine blocks dopamine receptors in the brain, particularly in areas that control nausea and balance. By interfering with dopamine signaling, it can reduce nausea, vomiting, and dizziness. In some cases, this dopamine-blocking effect can also help with agitation or migraine symptoms.

It shows various neurol circuits involved in these processes, highlighting areas such as the area postrema and nucleus tractus solitarius (NTS) where dopamine receptors are blocked.

Absorption and Metabolism

When taken by mouth or suppository, prochlorperazine is absorbed into the bloodstream and metabolized in the liver. Its effects can begin within 30 to 60 minutes, depending on the route of administration and individual factors like a person’s age and health status.

Uses and Benefits of Prochlorperazine

Prochlorperazine maleate belongs to the phenothiazine class of drugs and works primarily by blocking dopamine receptors in the brain, which helps reduce nausea, dizziness, and other related symptoms.

FDA-Approved Uses of Prochlorperazine

According to the U.S. Food and Drug Administration (FDA), prochlorperazine maleate is officially approved for the treatment of:

  • Severe nausea and vomiting, including cases related to surgery, chemotherapy, or gastrointestinal illness
  • Schizophrenia, including both non-psychotic and psychotic subtypes, in adults
  • Short-term treatment of generalized non-psychotic anxiety in adults (for up to 12 weeks)

These uses have been evaluated for safety and effectiveness through clinical trials and regulatory review. Prochlorperazine should only be used under the supervision of a qualified healthcare provider.

Other Common Medical Uses (Off-Label)

In addition to its FDA-approved uses, prochlorperazine may be prescribed “off-label” for conditions where clinical experience supports its benefit, even though these indications are not specifically approved by the FDA. These uses should always be discussed with and supervised by a medical professional.

  • Treating Nausea and Vomiting:  Beyond FDA-approved indications, prochlorperazine is often prescribed off-label for less severe forms of nausea and vomiting related to motion sickness and viral gastroenteritis
  • Managing Vertigo and Dizziness: For inner ear disorders such as labyrinthitis or Ménière’s disease, prochlorperazine may reduce the brain's sensitivity to motion and restore a sense of balance.
  • Migraines: In emergency departments and outpatient settings, prochlorperazine is sometimes used off-label to treat acute migraine attacks, especially when accompanied by nausea or vomiting. 

Other Applications

Though less common, prochlorperazine may also be considered for:

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  • Severe hiccups
  • Acute agitation in psychiatric settings
  • As an adjunct therapy in some neurological conditions

Note: Off-label use refers to prescribing an FDA-approved medication for an indication not included in the official labeling. These uses are based on clinical judgment and peer-reviewed evidence but should only be considered under the guidance of a healthcare provider.

Dosage and Administration

Proper dosage is essential for both safety and effectiveness. Prochlorperazine is available as a tablet, suppository, and injection. The prescribed amount depends on the treated condition and the patient’s age, weight, severity of symptoms, and medical history. 

Recommended Dosages for Various Conditions

The following examples reflect typical prescribing doses

  • Nausea and vomiting: 5–10 mg taken up to three or four times per day; maximum dose of 40 mg per day.
  • Vertigo: Initial doses may be 5 mg taken 2–3 times daily, adjusted as needed.
  • Migraine: A 10 mg dose may be used, sometimes with additional pain relievers.

A qualified healthcare provider should always determine individual dosing. 

Side Effects and Precautions

While prochlorperazine can be highly effective, it’s important to be aware of its side effect profile and use it under medical supervision, particularly for long-term treatment.

Common Side Effects

These side effects are generally mild and may resolve as your body adjusts:

  • Drowsiness or fatigue
  • Dizziness when standing up (orthostatic hypotension)
  • Blurred vision
  • Constipation or dry mouth
  • Restlessness or mild jitteriness

If these symptoms persist or interfere with daily functioning, contact your provider.

Rare But Serious Side Effects

These serious side effects are rare but require immediate medical attention if they occur:

  • Extrapyramidal symptoms (EPS): These include tremors, rigidity, or involuntary movements and may occur with prolonged use or in higher doses.
  • Tardive dyskinesia: A risk with long-term use, especially in older adults, involving repetitive or jerky facial movements.
  • Neuroleptic Malignant Syndrome (NMS): A rare but potentially life-threatening condition with fever, muscle stiffness, and altered mental status.
  • Severe allergic reactions: Such as rash, swelling, or difficulty breathing.

Seek prompt medical care if you experience these symptoms.

Drug Interactions and Contraindications

Contraindications for prochlorperazine use include:

  • Concurrent use with sedatives, alcohol, or opioids can enhance drowsiness and increase the risk of falls.
  • Use with anticholinergic medications (e.g., scopolamine, atropine)
  • May interact with antidepressants, blood pressure medications, or other dopamine-affecting drugs.
  • Contraindicated in people with bone marrow suppression, Parkinson’s disease, cardiac conduction issues, or severe liver dysfunction.

Special Considerations for Elderly Patients

Older adults may be more prone to confusion, sedation, and extrapyramidal symptoms. Use of the lowest effective dose and close monitoring is advised.

Monitoring and Safety Tips

A healthcare professional should monitor patients taking prochlorperazine on a long-term basis. Assessments typically include:

  • Periodic neurological assessments 
  • In patients who are overweight or have diabetes mellitus, fasting plasma glucose or hemoglobin A1C measured four months after starting any antipsychotic and then yearly.
  • Lipid serum concentrations every six months to two years

Always inform your healthcare provider about any other medications or supplements.

Maximizing Benefits and Minimizing Risks

Getting the most out of your medication while reducing the chances of side effects requires both awareness and consistency.

Tips for Taking Prochlorperazine Safely

  • Take exactly as prescribed.
  • Do not drive or operate heavy machinery until you know how it affects you.
  • Avoid alcohol or other sedating medications unless approved by your doctor.
  • Store tablets and suppositories away from heat and moisture.
  • Always consult your healthcare provider before making any changes to your medication routine.

Lifestyle Adjustments to Complement Treatment

  • Stay hydrated if you are managing nausea or vomiting.
  • Avoid triggers like strong smells or certain foods when possible.
  • Incorporate gentle movement or vestibular exercises if treating vertigo (under supervision).

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Key Takeaways

  • Prochlorperazine maleate is a prescription medication used to manage nausea, vomiting, vertigo, and migraine symptoms.
  • It works by blocking dopamine receptors in the brain, helping to reduce motion sensitivity and nausea signals.
  • Available in tablet, suppository, and injectable forms, it is often used in hospital and outpatient settings.
  • Common side effects include drowsiness, dry mouth, and dizziness, while serious side effects like movement disorders are rare but possible.
  • Elderly patients may require lower doses due to increased sensitivity to the drug’s effects.
  • Prochlorperazine should not be taken with alcohol or sedatives without medical guidance.
  • Patients should consult a healthcare provider if symptoms worsen or experience unusual reactions.

Prochlorperazine maleate is a trusted and effective option for managing symptoms like nausea, vertigo, and migraines. When used under the guidance of a healthcare professional, it can significantly improve quality of life. Like all medications, it carries risks—but with proper use and monitoring, the benefits often outweigh the potential downsides.

If you're considering prochlorperazine or have been prescribed it, speak with your healthcare provider about what to expect and how to take it safely.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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