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Indications/Uses
Schizoprenia and other psychoses (especially paranoia); mania and hypomania.
In anxiety, psychomotor agitation excitement, violent or dangerously impulsive behavior. It is used as an adjunct in the short-term management of these conditions.
Nausea and vomiting of terminal illness (where other drugs have failed or are not available).
Induction of hypothermia is facilitated by Laractyl which prevents shivering and causes vasodilation.
Childhood schizoprenia and autism.
In anxiety, psychomotor agitation excitement, violent or dangerously impulsive behavior. It is used as an adjunct in the short-term management of these conditions.
Nausea and vomiting of terminal illness (where other drugs have failed or are not available).
Induction of hypothermia is facilitated by Laractyl which prevents shivering and causes vasodilation.
Childhood schizoprenia and autism.
Dosage/Direction for Use
Adults: Excessive Anxiety Tension and Agitation: Oral Dose: Initially, 25 mg thrice daily or 75 mg at bedtime increasing daily amounts of 25 mg to an effective maintenance dose. This is usually in the range of 75-300 mg daily, but some patients may require 1 g daily.
Elderly or Debilitated Patients: Start with 1/3 to ½ the usual adult dose with a more gradual increase in dosage.
Dosage should be low in begin with and gradually increase under close supervision until the optimum dosage within the recommended range for the individual is reached. Individuals vary considerably and the optimum dose may be affected by the formulation used.
Elderly or Debilitated Patients: Start with 1/3 to ½ the usual adult dose with a more gradual increase in dosage.
Dosage should be low in begin with and gradually increase under close supervision until the optimum dosage within the recommended range for the individual is reached. Individuals vary considerably and the optimum dose may be affected by the formulation used.
Administration
May be taken with or without food: May be taken w/ meals to reduce GI discomfort.
Contraindications
Pregnancy, lactation.
Special Precautions
Laractyl should be avoided in patients with liver or renal dysfunction, epilepsy, Parkinson's disease, hypothyroidism, cardiac failure, pheochromocytoma, myasthenia gravis and prostate hypertrophy. It should be avoided in patients known to be hypersensitive to phenothiazines or with a history of narrow angle glaucoma.
Effects on the Ability to Drive or Operate Machinery: Patients should be warned about drowsiness during early days of treatment and advised not to drive or operate machinery.
Use in pregnancy & lactation: There is inadequate evidence on the safety of Laractyl in human pregnancy but it has been widely used for many years without apparent ill consequence. There is evidence of harmful effects in animals. Like other drugs, it should be avoided in pregnancy unless the physician considers it essential.
It may occasionally prolong labor and at such a time should be withheld until the cervix is dilated 3-4 cm. Possible adverse effect on the neonate include lethargy or paradoxical hyperexcitability, tremor and low Apgar score. Laractyl being excreted in the milk, breasfeeding should be suspended during treatment.
Use in the elderly: It should be used with caution in the elderly, particularly during very hot or very cold weather (risk of hyper-hypothermia.)
The elderly are particularly susceptible to postural hypotension.
Effects on the Ability to Drive or Operate Machinery: Patients should be warned about drowsiness during early days of treatment and advised not to drive or operate machinery.
Use in pregnancy & lactation: There is inadequate evidence on the safety of Laractyl in human pregnancy but it has been widely used for many years without apparent ill consequence. There is evidence of harmful effects in animals. Like other drugs, it should be avoided in pregnancy unless the physician considers it essential.
It may occasionally prolong labor and at such a time should be withheld until the cervix is dilated 3-4 cm. Possible adverse effect on the neonate include lethargy or paradoxical hyperexcitability, tremor and low Apgar score. Laractyl being excreted in the milk, breasfeeding should be suspended during treatment.
Use in the elderly: It should be used with caution in the elderly, particularly during very hot or very cold weather (risk of hyper-hypothermia.)
The elderly are particularly susceptible to postural hypotension.
Adverse Reactions
Minor Adverse Reaction: Nasal stuffiness, dry mouth, insomnia, agitation.
Liver Function: Jaundice, usually transient, occurs in a very small percentage of patients taking Laractyl. A premonitory sign may be sudden onset of fever after 1-3 weeks of treatment followed by the development of jaundice. Laractyl jaundice has the biochemical and other characteristics of obstructive jaundice and is associated with obstructions of the canaliculi by bile thrombi; the frequent resence of an accompanying eosinophilia indicates the allergic nature of this phenomenon. Treatment should be withheld on the development of jaundice.
Cardio-Respiratory: Hypotension, usually postural, commonly occurs. Elderly or volume-depleted subjects are particularly susceptible; it is more likely to occur after IM administration.
Cardiac arrhythmias, including atrial arrhythmia, AV block, ventricular tachycardia and fibrillation have been reported during neurologic therapy, possibly related to dosage. Preexisting cardiac dosage, old age, hypokalemia and concurrent tricyclic antidepressants may predispose. ECG changes, usually benign, include widened QT interval, ST depression, U-waves and T-waves changes.
Respiratory depression is possible in susceptible patients.
Blood: A mild leucopenia occurs in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely; it is not dose-related. The occurrence of unexplained infections or fever requires immediate hematological investigation.
Extrapyramidal: Acute dystonias or dykinesias, usually transitory are more common in children and young adults and usually occur within the first 4 days of treatment or after dosage increases.
Akathisia characteristically occurs after large initial doses.
Parkinsonism is more common in adults and the elderly. It usually develops after weeks or months of treatment. One or more of the following may be seen: Tremor, rigidity, akinesia or other features of parkinsonism. Commonly, just tremor.
Tardive Dyskinesia: If this occurs, is it usually but not necessarily, after prolonged or high dosage. It can even occur after treatment has been stopped. Dosage should be kept low whenever possible.
Skin and Eyes: Contact skin sensitization is a serious but rare complication in those frequently handling preparations of Laractyl. The greatest care must be taken to avoid contact of Laractyl with the skin. Skin rashes of various kinds may also be seen in patients treated with Laractyl. Patients on high dosage should be warned that they may develop photosensitivity in sunny weather and should avoid exposure to direct sunlight.
Liver Function: Jaundice, usually transient, occurs in a very small percentage of patients taking Laractyl. A premonitory sign may be sudden onset of fever after 1-3 weeks of treatment followed by the development of jaundice. Laractyl jaundice has the biochemical and other characteristics of obstructive jaundice and is associated with obstructions of the canaliculi by bile thrombi; the frequent resence of an accompanying eosinophilia indicates the allergic nature of this phenomenon. Treatment should be withheld on the development of jaundice.
Cardio-Respiratory: Hypotension, usually postural, commonly occurs. Elderly or volume-depleted subjects are particularly susceptible; it is more likely to occur after IM administration.
Cardiac arrhythmias, including atrial arrhythmia, AV block, ventricular tachycardia and fibrillation have been reported during neurologic therapy, possibly related to dosage. Preexisting cardiac dosage, old age, hypokalemia and concurrent tricyclic antidepressants may predispose. ECG changes, usually benign, include widened QT interval, ST depression, U-waves and T-waves changes.
Respiratory depression is possible in susceptible patients.
Blood: A mild leucopenia occurs in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely; it is not dose-related. The occurrence of unexplained infections or fever requires immediate hematological investigation.
Extrapyramidal: Acute dystonias or dykinesias, usually transitory are more common in children and young adults and usually occur within the first 4 days of treatment or after dosage increases.
Akathisia characteristically occurs after large initial doses.
Parkinsonism is more common in adults and the elderly. It usually develops after weeks or months of treatment. One or more of the following may be seen: Tremor, rigidity, akinesia or other features of parkinsonism. Commonly, just tremor.
Tardive Dyskinesia: If this occurs, is it usually but not necessarily, after prolonged or high dosage. It can even occur after treatment has been stopped. Dosage should be kept low whenever possible.
Skin and Eyes: Contact skin sensitization is a serious but rare complication in those frequently handling preparations of Laractyl. The greatest care must be taken to avoid contact of Laractyl with the skin. Skin rashes of various kinds may also be seen in patients treated with Laractyl. Patients on high dosage should be warned that they may develop photosensitivity in sunny weather and should avoid exposure to direct sunlight.
Drug Interactions
The CNS depressant actions of Laractyl and other neuroleptic agents may be intensified (additively) by alcohol, barbiturates and other sedatives. Respiratory depression may occur.
The hypotensive effect of most anithypertensive drugs especially α-adrenoreceptor blocking agents may be exaggerated by Laractyl.
The mild anticholinergic effect of Laractyl may be enhanced by other anticholinergic drugs possibly leading to constipation, heat stroke, etc.
The action of some drugs may be opposed by Laractyl: These include amphetamine, levodopa, clonidine, guanethidine, adrenaline.
Anticholinergic agents may reduce the antipsychotic effect of Laractyl.
Some drugs interfere with absorption of neuroleptic agents: Antacids, anti-parkinson, lithium. Increases or decreases in plasma concentration of a number of drugs eg, propranolol, phenobarbitone have been observed but were not of clinical significance.
High doses of Laractyl reduce the response to hypoglycemic agents, the dosage of which might have been raised.
Documented adverse clinically significant interactions occur with alcohol, guanethidine and hypoglycemic agents. Adrenaline must not be used in patients overdosed with Laractyl.
Simultaneous administration of desferrioxamine and prochlorperazine has been observed to induce a transient metabolic encephalopathy characterized by loss of consciousness for 48-72 hrs. It is possible that this may occur with Laractyl since it shares many of the pharmacological activities of prochlorperazine.
The hypotensive effect of most anithypertensive drugs especially α-adrenoreceptor blocking agents may be exaggerated by Laractyl.
The mild anticholinergic effect of Laractyl may be enhanced by other anticholinergic drugs possibly leading to constipation, heat stroke, etc.
The action of some drugs may be opposed by Laractyl: These include amphetamine, levodopa, clonidine, guanethidine, adrenaline.
Anticholinergic agents may reduce the antipsychotic effect of Laractyl.
Some drugs interfere with absorption of neuroleptic agents: Antacids, anti-parkinson, lithium. Increases or decreases in plasma concentration of a number of drugs eg, propranolol, phenobarbitone have been observed but were not of clinical significance.
High doses of Laractyl reduce the response to hypoglycemic agents, the dosage of which might have been raised.
Documented adverse clinically significant interactions occur with alcohol, guanethidine and hypoglycemic agents. Adrenaline must not be used in patients overdosed with Laractyl.
Simultaneous administration of desferrioxamine and prochlorperazine has been observed to induce a transient metabolic encephalopathy characterized by loss of consciousness for 48-72 hrs. It is possible that this may occur with Laractyl since it shares many of the pharmacological activities of prochlorperazine.
Storage
Store at temperatures not exceeding 30°C. Protect from light.
Action
Pharmacokinetics: Laractyl is a phenothiazine neuroleptic that is rapidly absorbed and widely distributed in the body. It is metabolized in the liver and excreted in the urine and bile. While plasma concentration of Laractyl itself rapidly declines, excretion of Laractyl metabolites are very slow. Laractyl is highly bound to plasma protein. It readily diffuses across the placenta. Small quantities have been detected in milk from treated women. Children require smaller dosage/kg than adults.
MedsGo Class
Antipsychotics
Features
Brand
Laractyl
Full Details
Dosage Strength
200 mg
Drug Ingredients
- Chlorpromazine
Drug Packaging
Tablet 100's
Generic Name
Chlorpromazine Hydrochloride
Dosage Form
Tablet
Registration Number
DR-XY20207
Drug Classification
Prescription Drug (RX)