Generic Compazine

Introduction

Compazine (prochlorperazine) is a phenothiazine‑derived medication principally used to control severe nausea and vomiting, and to treat certain psychotic disorders. In the United Kingdom it is prescribed under specialist supervision for conditions such as chemotherapy‑induced emesis, postoperative nausea, and acute psychosis. The active compound, prochlorperazine, belongs to the broader “mental illness” drug group because of its dopamine‑antagonist properties. Although originally marketed under the brand name Compazine, the same molecule is available from several manufacturers and is listed under other brand names such as Stemetil and Prochlorperazine tablets.

What is Compazine?

Compazine is a branded formulation that contains the antipsychotic and anti‑emetic agent prochlorperazine. It was first developed in the 195s by a collaboration between Amdipharm (now part of Amdipharm–Mckesson) and the United States National Institutes of Health. In the UK, the product is approved by the Medicines and Healthcare products Regulatory Agency (MHRA) and is supplied as oral tablets, intramuscular injection, and, in some jurisdictions, a rectal suppository.

Other well‑known brand names that contain the identical active compound include Stemetil, Progast, and generic prochlorperazine tablets marketed by multiple European wholesalers. Our online pharmacy provides this generic alternative at a price close to the manufacturer’s cost, offering a cost‑effective option for patients who have been prescribed prochlorperazine.

How Compazine Works

Prochlorperazine exerts its therapeutic effect primarily by blocking dopamine D₂ receptors in the chemoreceptor trigger zone (CTZ) of the medulla and within the vestibular nuclei. By reducing dopamine signalling, the drug diminishes the neural impulses that initiate the vomiting reflex. In psychotic states, dopaminergic overactivity in mesolimbic pathways contributes to hallucinations and delusions; antagonism at D₂ receptors therefore alleviates these symptoms.

The onset of anti‑emetic action after oral administration is typically 30–60 minutes, with a peak effect at 2–4 hours. Intramuscular injection produces a faster response, often within 15 minutes. Prochlorperazine has a half‑life of approximately 6–8 hours in healthy adults, and is eliminated chiefly via hepatic metabolism followed by renal excretion.

Conditions Treated with Compazine

• Chemotherapy‑induced nausea and vomiting (CINV): Prochlorperazine is recommended as part of a multimodal anti‑emetic regimen for patients receiving highly emetogenic chemotherapy. Studies in NHS oncology centres show a reduction in grade 3–4 vomiting episodes when combined with a 5‑HT₃ antagonist.
• Post‑operative nausea and vomiting (PONV): Guidelines from the Royal College of Anaesthetists include prochlorperazine as an alternative to ondansetron for patients at moderate risk of PONV.
• Vertigo and motion sickness: The drug’s vestibular D₂ blockade reduces the sensation of vertigo, particularly in vestibular migraine and Ménière’s disease.
• Acute psychosis and schizophrenia: For patients intolerant of atypical antipsychotics, prochlorperazine offers a traditional, dopamine‑targeted option. Clinical audits in UK psychiatric hospitals record comparable efficacy to haloperidol at lower doses, albeit with a different side‑effect profile.
• Severe refractory hiccups: Limited case series from UK tertiary centres suggest benefit in persistent hiccups unresponsive to conventional therapy.

Who is Compazine For?

Compazine is suitable for adults (≥ 18 years) who require rapid control of nausea, vomiting, or psychotic symptoms and for whom first‑line agents are ineffective or contraindicated. Typical candidates include:

• Cancer patients undergoing moderate to high‑emetic‑risk chemotherapy who have failed a 5‑HT₃ antagonist alone.
• Post‑surgical patients experiencing vomiting despite standard prophylaxis.
• Individuals with acute exacerbations of schizophrenia or schizoaffective disorder who have demonstrated tolerance to phenothiazines
• Patients with vestibular disorders where dopamine antagonism provides symptomatic relief.

Contra‑indications encompass a known hypersensitivity to phenothiazines, severe central nervous system depression, and a history of uncontrolled extrapyramidal reactions. Caution is advised in the elderly, patients with significant cardiac conduction abnormalities, and those with hepatic or renal impairment.

Risks, Side Effects, and Interactions

Common

• Drowsiness sedation
• Dry mouth, constipation, or urinary retention
• Orthostatic hypotension (especially with rapid dose escalation)
• Light‑headedness or dizziness
• Mild extrapyramidal symptoms (e.g., tremor, restlessness)

Rare

• Hyperprolactinaemia leading to galactorrhoea or menstrual irregularities
• Photosensitivity reactions on prolonged sun exposure
• Significant QT‑interval prolongation on ECG (monitor in patients with existing cardiac disease)
• Neuroleptic malignant syndrome (extremely rare but life‑threatening)

Serious

• Severe extrapyramidal reactions such as acute dystonia, akathisia, or parkinsonism
• Tardive dyskinesia with long‑term use, characterised by involuntary facial movements
• Agranulocytosis (marked reduction in white blood cells)
• Life‑threatening allergic reactions, including anaphylaxis

Drug–drug interactions

• Anticholinergics (e.g., atropine, benztropine) may potentiate urinary retention and constipation.
• CNS depressants (opioids, benzodiazepines, alcohol) increase sedation and respiratory depression risk.
• Other dopamine antagonists (haloperidol, chlorpromazine) can amplify extrapyramidal side‑effects.
• QT‑prolonging agents (quinidine, macrolide antibiotics, some anti‑arrhythmics) may synergistically lengthen the QT interval, raising torsades de pointes risk.
• Lithium: concomitant use can heighten neurotoxicity; plasma lithium levels should be monitored closely.

Patients should disclose all concomitant medications, including over‑the‑counter and herbal products, to their prescriber.

Practical Use: Dosing, Missed Dose, Overdose

Standard oral dosing

• Nausea/Vomiting: 5 – 10 mg initially; may repeat every 4–6 hours. Maximum 40 mg per day.
• Psychotic disorders: 5 – 10 mg two to three times daily; total daily dose rarely exceeds 30 mg.

Intramuscular injection (for rapid control): 5 – 10 mg deep IM, repeat after 30 minutes if required; max 30 mg per day.

Missed dose

If a dose is forgotten and the next scheduled dose is more than 4 hours away, take the missed dose. If the next dose is sooner, skip the missed dose and continue with the regular schedule. Do not double‑dose to compensate.

Overdose

Symptoms may include profound sedation, hypotension, severe extrapyramidal reactions, and respiratory depression. Immediate medical attention is essential. Gastric lavage or activated charcoal may be considered within the first hour of ingestion. Supportive care, including cardiovascular monitoring and possibly antagonism with physostigmine for severe anticholinergic toxicity, is recommended.

Precautions

• Take tablets with a full glass of water; do not crush unless advised by a pharmacist.
• Alcohol potentiates sedation and orthostatic effects; limit intake.
• In patients with hepatic or renal insufficiency, dose reductions (often 25–50 % of the standard dose) are advisable.
• Pregnant or breastfeeding women should only use prochlorperazine when the benefit clearly outweighs potential fetal or infant risk; consult a specialist.

Buying Compazine from Our Online Pharmacy

Compazine can be purchased safely from our online pharmacy in the UK. We operate as a pharmacy‑broker service, partnering with licensed overseas suppliers that meet European Good Manufacturing Practice (GMP) standards. Key advantages include:

• Affordable pricing: Our cost structure is near‑manufacturer, delivering savings of up to 40 % compared with traditional high‑street pharmacies.
• Verified quality: Every batch undergoes independent laboratory testing for potency, purity, and sterility before dispatch.
• Guaranteed delivery: Discreet packaging is shipped via express courier (delivery within 7 days) or regular airmail (approximately 3 weeks), with real‑time tracking available.
• Online‑only accessibility: For patients living in remote areas or those experiencing supply shortages in local pharmacies, our service provides a reliable alternative while respecting privacy.

We comply fully with UK import regulations for personal medication use, ensuring that each order meets the Medicines Act provisions and MHRA guidance.

FAQ

• Is Compazine available in both brand‑name and generic forms in the UK?
  Yes. Compazine is the original brand name, while generic prochlorperazine tablets are marketed by several European wholesalers. The generic versions contain the same active ingredient and are typically less expensive.

• What should I do with any leftover tablets after my course is finished?
  Unused tablets should be returned to a pharmacy waste collection point or disposed of in a household‑solid‑waste container after crushing them, to prevent accidental ingestion.

• Can I travel internationally with Compazine, and are there any customs restrictions?
  You may bring a personal supply for up to three months’ use, provided it is in its original packaging with a copy of the prescription label. Declare the medication at customs if required, and keep it in your hand luggage to avoid temperature extremes.

• Does the formulation differ between the UK and continental Europe?
  The active ingredient, prochlorperazine, remains identical, but excipients such as lactose or magnesium stearate may vary. These differences are generally clinically insignificant but may affect patients with specific allergies.

• How stable is Compazine at high temperatures?
  The tablets are stable at room temperature (15–30 °C). Exposure to prolonged heat above 40 °C may degrade the phenothiazine core, reducing potency. Store in a cool, dry place away from direct sunlight.

• Are there any special warnings for people of Asian descent taking Compazine?
  No ethnicity‑specific warnings are listed by the MHRA. However, some Asian populations have a higher prevalence of glucose‑6‑phosphate dehydrogenase (G6PD) deficiency, which can increase susceptibility to drug‑induced hemolysis; monitor blood counts if other risk factors exist.

• Is prochlorperazine detectable on standard drug‑screening tests?
  Routine workplace or sports drug screens typically do not target phenothiazine antipsychotics, so Compazine is unlikely to be flagged unless a specific test for antipsychotic agents is requested.

• What are the differences between oral tablets and intramuscular injection in terms of side‑effects?
  The injection bypasses first‑pass metabolism, leading to a quicker onset but a slightly higher incidence of local pain or muscle irritation. Systemic side‑effects (e.g., sedation, extrapyramidal symptoms) are comparable across routes when doses are equivalent.

• Can Compazine be used for migraine‑associated nausea?
  Yes. Because migraine often involves vestibular stimulation, prochlorperazine’s anti‑emetic and vestibular‑modulating properties can alleviate both headache and nausea, as reported in several UK headache clinics.

• Do UK pharmacies require a special license to dispense Compazine?
  Compazine is a prescription‑only medicine (POM) under UK law, meaning only a registered pharmacist may dispense it when presented with a valid NHS or private prescription. Our online pharmacy works with accredited prescribers to fulfil legitimate orders.

Glossary

Dopamine D₂ receptor

A protein on nerve cells that binds dopamine, a neurotransmitter involved in mood, movement, and the vomiting reflex. Blocking this receptor reduces psychotic symptoms and nausea.

Extrapyramidal symptoms (EPS)

Movement‑related side‑effects such as tremor, muscle rigidity, or involuntary jerks that can occur with dopamine‑blocking drugs.

Half‑life

The time required for the concentration of a drug in the bloodstream to decrease by 50 %. Prochlorperazine’s half‑life is about 6–8 hours in healthy adults.

QT interval

A measurement on an electrocardiogram representing the time for ventricular depolarisation and repolarisation. Prolongation can increase the risk of dangerous arrhythmias.

⚠️ Disclaimer

The information provided about Compazine is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Compazine for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.