Prochlorperazine
Acute migraine (ED treatment), Nausea and vomiting, Vertigo-associated nausea
Indications
- Acute migraine (ED treatment)
- Nausea and vomiting
- Vertigo-associated nausea
Adult dosing
- migraine: dose: 10; unit: mg; route: IV; interval: Give with diphenhydramine 25mg IV to prevent akathisia; fixed: true; nausea: dose: 10; unit: mg; route: IV/IM/PO; interval: q6-8h PRN; fixed: true
Contraindications
- QTc prolongation
- Parkinson disease
- Children <2 years
- Known dystonic reactions to dopamine antagonists
Clinical pearls
- Prochlorperazine 10mg IV + diphenhydramine 25mg IV is more effective than sumatriptan for acute migraine in the ED
- Always co-administer diphenhydramine to prevent akathisia (30% incidence without)
- Infuse over 15-20 min to reduce hypotension risk
- Avoid in Parkinson disease and Lewy body dementia
Source and review
- Friedman et al., Ann Emerg Med 2014. Last reviewed: 2024-11-01