Basic Chlorpromazine Information

• INN (International Nonproprietary Name): Chlorpromazine
• Brand Names Available in Australia: Largactil
• ATC Code: N05AA01
• Forms & Dosages: Tablets (25mg, 100mg), Liquid
• Manufacturers in Australia: Various generic manufacturers
• Registration Status in Australia: Registered
• OTC / Rx Classification: Prescription-only

Morning Vs Evening Dosing (Australian Daily Routines)

Dosing schedules for chlorpromazine can greatly influence its effectiveness and the patient’s daily experience. In Australia, many patients often choose between morning and evening dosing based on their unique routines. Morning doses may suit those with active days, aiding in managing symptoms throughout waking hours. Conversely, evening doses can be beneficial for individuals whose symptoms present more at night or for those who need to mitigate insomnia. Determining the optimal time for chlorpromazine dosing involves various factors including work commitments, lifestyle activities, and the specific symptoms being addressed. These include considerations such as:

• Work hours: Aligning the medication schedule with work commitments can help better manage symptoms during the day.
• Daily routines: Personal habits and activities play a significant role in deciding whether morning or evening doses are more suitable.
• Symptom management: Tailoring doses based on when symptoms typically emerge can enhance overall well-being.

Taking With Or Without Meals

The absorption of chlorpromazine can be influenced by food intake, making it important for patients to consider their meal timings when taking this medication. Taking chlorpromazine with food can enhance absorption and may reduce some gastrointestinal side effects. Here’s some practical advice:

• With meals: Taking chlorpromazine during or after a meal can improve its absorption and help mitigate any potential stomach irritation.
• Avoid alcohol: Consuming alcohol should be avoided as it may exacerbate side effects, particularly sedation.
• Consistency is key: Be consistent in taking the medication relative to meals to maintain steady drug levels in the body.

• Dos:
  • Take the medication at the same time each day.
  • Consult a healthcare professional about combining food and medication.
• Don'ts:
  • Do not skip doses or double up on missed doses.
  • Avoid alcohol until you know how the medication affects you.

Safety Priorities

When it comes to taking chlorpromazine, safety is paramount. Various concerns arise, particularly regarding who should avoid using this medication. Understanding the guidelines can prevent adverse health effects.

Who should avoid it (TGA safety notices)

The Therapeutic Goods Administration (TGA) provides essential information on contraindications associated with chlorpromazine. Here are the key points to consider:

• Absolute contraindications: People with chronic or acute metabolic acidosis, severe renal impairment (eGFR <30 ml/min/1.73m²), hypersensitivity to chlorpromazine or its excipients, and severe hepatic insufficiency should not use this medication.
• Relative contraindications: Those with conditions that risk tissue hypoxia, such as cardiac failure, severe infections, or shock, need to use caution. Age over 80 without assessed renal function is also a concern, alongside those with alcohol abuse or those who will undergo procedures involving iodinated contrast media.

Particular attention should be given to vulnerable populations like the elderly or individuals with renal impairment, as they are at an increased risk.

Activities to limit (driving, machinery, workplace safety)

For individuals prescribed chlorpromazine, various activities require caution, especially regarding safety. The sedative effects of chlorpromazine can lead to reduced alertness and increased drowsiness, impacting daily activities significantly.

Safety guidelines emphasize the following precautions:

• Avoid driving or operating machinery, particularly when starting the medication or adjusting doses.
• Be cautious at work where physical safety is crucial, especially in roles requiring high attention to tasks or quick reflexes.

The overall impact of chlorpromazine on sedation and alertness means that daily activities may need to be adjusted, especially until individuals understand how their body reacts to this medication.

Dosage & Adjustments

General regimen (PBS-listed guidelines)

Questions often arise regarding the correct dosage of chlorpromazine and how to adjust it for specific needs.

Standard chlorpromazine dosages vary based on the condition being treated:

• Schizophrenia: Starting from 50 mg to 100 mg daily, increasing to 400 mg to 800 mg as needed.
• Hiccups: A dose of 25 mg taken three times a day has been effective.

The availability of dosage forms makes access to chlorpromazine straightforward for patients:

• Tablets: Available in strengths of 10, 25, and 100 mg for easy oral administration.
• Liquid form: Also available for those who struggle with swallowing tablets.

Special cases (elderly, Indigenous health, comorbidities)

Prescribing chlorpromazine requires extra caution for specific populations.

• Elderly patients: Start at the lower end of the dosing spectrum, considering potential increased sensitivity to side effects.
• Indigenous health: Be mindful of cultural factors and community support, tailoring communication and support for efficacy.
• Comorbid conditions: Assess renal function closely, given the increased risk of adverse effects in patients with renal impairments.

When prescribing, consider this checklist:

• Assess the patient's overall health status and medication schedule.
• Monitor for medication interactions.
• Adjust dosages based on the patient's response and side effects.

Delivery Options for Chlorpromazine