Prochlorperazine

• Refractory nausea/vomiting of pregnancy
• Hyperemesis gravidarum (2nd line)

D2 antagonism in CTZ; also H1 and muscarinic blockade contributing to antiemetic effect and side-effect profile.

• Buccal absorbs when you can't swallow
• Watch for dystonia in young women
• Avoid QT-prolonging combos

PO

5–10 mg TDS

Buccal

3–6 mg BD (between gum and upper lip)

IM

12.5 mg, repeat 6-hourly PRN

• AbsoluteParkinson's disease
• AbsoluteProlonged QT / concurrent QT drugs
• CautionElderly (stroke risk with antipsychotics)

• Extrapyramidal reactions (esp. young women)
• Sedation
• Postural hypotension
• QT prolongation
• Cholestatic jaundice (rare)

• • No consistent teratogenic signal
• • Neonatal extrapyramidal / withdrawal symptoms if used near term

• Ondansetron

  Caution

  Additive QT prolongation

• Levodopa

  Avoid

  Antagonised

• Alcohol / CNS depressants

  Caution

  Sedation

• 💡 Buccastem 3 mg absorbed transbuccally — useful when vomiting
• 💡 Reserve for cyclizine failures