Emectil 25 mg/5 ml (Syrup)

Indications

• Schizophrenia and other psychoses (especially paranoid), mania and hypomania
• Anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour
• Intractable hiccup
• Nausea and vomiting of terminal illness
• Childhood schizophrenia and autism

Pharmacology

• Neuroleptic action by blocking postsynaptic dopamine receptor
• Inhibition of hypothalamic and hypophyseal hormones release
• Antiemetic properties
• Serotonin-blocking and weak antihistaminic properties
• Slight ganglion-blocking activity

Dosage

• Initial dosage of 25 mg three times daily or 75 mg at bedtime for adults
• Maximum daily dosage in the range 75 to 300 mg, up to 1 g daily for some patients
• Dosage for children: 0.5 mg/kg bodyweight every 4 - 6 hours to a maximum recommended dose of 40 mg daily for 1-5 years
• Dosage for elderly: Start with a third to a half the usual adult dose with a more gradual increase in dosage
• Different dosage for intractable hiccup, nausea, and vomiting of terminal illness

Administration

May be taken with or without food. May be taken with meals to reduce GI discomfort

Interaction

• Interactions leading to decreased chlorpromazine levels with food, alcohol, and benztropine
• Antacids slow the absorption of chlorpromazine
• Lithium and chronic administration of barbiturates can increase clearance
• Interactions leading to increased chlorpromazine levels with tricyclic antidepressants and CYP1A2 inhibitors

Contraindications

• Circulatory collapse
• CNS depression
• Hypersensitivity reaction to phenothiazines or chlorpromazine
• Bone marrow depression
• Phaeochromocytoma
• Hepatic failure or active hepatic disease

Side Effects

• Postural hypotension
• ECG changes
• Dermatological reactions
• Elevated prolactin levels
• Gastrointestinal discomfort
• Immunological reactions
• Genitourinary issues
• Hematological abnormalities

Pregnancy & Lactation

• Pregnancy category C
• Reproductive toxicity in animal studies
• Teratogenic risk not evaluated in humans
• Excretion in breast milk

Precautions & Warnings

Avoid use in epilepsy, Parkinson’s disease, hypoparathyroidism, myasthenia gravis, and prostatic hypertrophy

Use in Special Populations

Elderly are more susceptible to adverse effects and require lower starting dosage

Therapeutic Class

• Anti-emetic drugs
• Phenothiazine drugs
• Phenothiazine related drugs

Storage Conditions

Keep below 30°C temperature, away from light and moisture, out of the reach of children

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