The drug is administered intramuscularly and intravenously. The doses and treatment regimens are set individually by the doctor, depending on the indicationth and the patient's condition.
With intramuscular injection, the chlorpromazine solution is diluted with 2-5 ml of 0.25-0.5% procaine solution or 0.9% sodium chloride solution. Enter deep into the muscle. With intravenous administration, the required amount of chlorpromazine solution is diluted with 5% or 40% dextrose solution, or 0.9% sodium chloride solution, administered slowly under the control of blood pressure.
Psychotic disorders.
Intramuscularly administered 25-50 mg (1-2 ml) once, if necessary, the dose is repeated after 1 hour, and then, if necessary, and taking into account tolerability every 3-12 hours for several days. In acute psychic excitement, 50-75 mg (2-3 ml) is administered intravenously in 20 ml of a 40% dextrose solution.
In anesthesiology, for the relief of anxiety before surgery, 12.5-25 mg (0.5-1 ml) is administered intramuscularly 1-2 hours before the operation.
Severe nausea and vomiting.
Enter intravenously once 25 mg (1 ml), if necessary and taking into account the tolerability dose is increased by 25-50 mg (1-2 ml) every 3-4 hours before the termination of vomiting. In anesthesiology, to stop nausea and vomiting during surgery, injected intramuscularly or intravenously. Intramuscular injection of 12.5 mg (0.5
ml) once, if necessary and taking into account the tolerability dose is repeated after 30 minutes. Intravenous 25 mg, diluted to a concentration of 1 mg / ml 0.9% solution of sodium chloride, at a rate of not more than 2 mg / min.
Persistent hiccups.
Enter intramuscularly 25-50 mg (1-2 ml) 3-4 times a day or intravenously 25-50 mg (1-2 ml), diluted in 500-1000 ml of 0.9% sodium chloride solution at a rate of 1 mg / min.
For relief of psychomotor agitation, attacks of vomiting and hiccups in cases of cerebral circulation disorders, it is prescribed as part of a "lytic mixture" containing 25-50 mg (1-2 ml) of chlorpromazine, 50 mg of promethazine solution or 40 mg of diphenhydramine solution, 20 mg of trimeridine solution. The "lytic mixture" is administered intramuscularly or intravenously 1-2 times a day.
Diseases accompanied by increased muscle tone.
Tetanus: Intramuscularly administered 25-50 mg (1-2 ml) 3-4 times a day, if necessary, and taking into account tolerability, the dose is gradually increased. Intravenous 25-50 mg, diluted to a concentration of about 1 mg / ml 0.9% solution of sodium chloride, with
at a rate of 1 mg / ml.
Acute "intermittent" porphyria:
Enter intramuscularly 25 mg (1 ml) every 6-8 h until the patient can take chlorpromazine inside.
Elderly, as well as weakened or emaciated patients, treatment with the drug begins with a lower dose, gradually increasing it with a view to the necessity and tolerability.
For children from 6 months to 12 years, the drug is administered: with psychotic disorders, intramuscularly 0.55 mg / kg (15 mg / m) every 6-8 hours; with nausea, vomiting during surgery - intramuscularly 0.275 mg / kg, if necessary taking into account the tolerability dose is repeated after 30 minutes, or intravenously 0.275 mg / kg, diluted to a concentration of about 1 mg / ml 0.9% solution of sodium chloride at a rate of 1 mg / 2 min; for relief of anxiety before surgery - intramuscularly 0.55 mg / kg for 1-2 hours before surgery; for tetanus - intramuscularly 0.55 mg / kg every 6-8 hours or intravenously 0.55 mg / kg, diluted to a concentration of approximately 1 mg / ml with 0.9% sodium chloride solution at a rate of 1 mg / 2 min.
The maximum daily intake of chlorpromazine for adults with intramuscular injection is 1000 mg, with intravenous administration 250 mg.
Precautions for use
Chlorpromazine, like other neuroleptic phenothiazines, can potentiate interval lengthening QT, increasing the risk of ventricular arrhythmias. Before appointment the patient should be examined (biochemical status, ECG) for the purpose of elimination of possible risk factors (cardiovascular diseases, lengthening interval QT, in anamnesis or with concomitant therapy, metabolic disorders, such as hypoglycaemia, hypocalcemia, hypomagnesemia). When taking neuroleptics phenotiazinovogo number of cases of sudden death, including, possibly, caused by cardiac causes.
To avoid an abrupt change in blood pressure, parenteral administration of chlorpromazine is performed in the patient's prone position, after administration, patients should stay in the reclining position for at least 1-1.5 hours (a sharp transition to a vertical position can lead to an orthostatic collapse).
When parenteral administration of chlorpromazine should avoid the possibility of getting the drug on the mucous membranes and skin because of the risk of developing contact dermatitis.
Neuroleptic malignant syndrome can occur at any time during treatment with neuroleptics and lead to death. In elderly patients with psychoses due to dementia, the development of irreversible dyskinesia is possible. When there are signs of neuroleptic syndrome and tardive dyskinesia, treatment should be canceled. Hyperthermia is one of the symptoms of malignant neuroleptic syndrome, so when it occurs chlorpromazine it should immediately be canceled and the cause of its occurrence established.
During the period of therapy, due to the possibility of developing photosensitization of the skin, UV irradiation should be avoided, including prolonged exposure to the sun.
During the treatment period, do not drink alcohol.