Prochlorperazine Contraindications and Precautions

Absolute Contraindications

• The American College of Oncology recommends that prochlorperazine is absolutely contraindicated in patients with Parkinson's disease due to high risk of extrapyramidal symptoms (EPS) 1, 4
• The American College of Oncology recommends that prochlorperazine is absolutely contraindicated in patients with dementia with Lewy bodies due to severe risk of EPS 1, 4

Strong Cautions (Relative Contraindications)

• The Gastroenterology society recommends that prochlorperazine should be used with extreme caution in patients with a history of seizure disorder as it can lower seizure threshold 2, 3
• The Gastroenterology society recommends that prochlorperazine should be used with caution in patients with dementia due to increased risk of adverse neurologic effects 2, 3
• The Gastroenterology society recommends that prochlorperazine should be used with caution in patients with glaucoma as anticholinergic effects may worsen intraocular pressure 2, 3
• The Gastroenterology society recommends that prochlorperazine should be used with careful monitoring in patients with a history of leukopenia or neutropenia as it can cause drug-induced leukopenia or neutropenia 2, 3
• The Cancer Treatment Reviews society recommends that prochlorperazine may prolong QTc interval and carries risk of neuroleptic malignant syndrome, and concurrent use with other QT-prolonging medications should be avoided when possible 2, 3, 5

Special Population Warnings

• The Annals of Oncology society recommends that lower doses of prochlorperazine are recommended in older or frail patients due to increased fall risk 1, 4