Prochlorperazine (Compazine): How This Phenothiazine Works for Nausea, Anxiety, and Schizophrenia

Last updated: August 24, 2026

Prochlorperazine is a first-generation (typical) phenothiazine. Tablets usually come as 5 mg and 10 mg of prochlorperazine as the maleate. The historic brand Compazine is discontinued. Compro and Procomp appear on older brand lists. Generic tablets and rectal suppositories remain. Prochlorperazine is not a controlled substance. The FDA label lists three adult uses: control of severe nausea and vomiting, treatment of schizophrenia, and short-term treatment of generalized non-psychotic anxiety under tight dose and duration limits.

This guide covers what prochlorperazine treats, how nausea, anxiety, and psychosis dosing differ, why tardive dyskinesia and the dementia boxed warning matter, and which parts of care a telehealth visit can handle. It is educational, not a diagnosis or a promise that any plan will pay for a specific medicine.

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What is prochlorperazine?

According to MedlinePlus (revised February 15, 2018), prochlorperazine tablets and suppositories control severe nausea and vomiting. Tablets also treat schizophrenia symptoms and, on a short-term basis, anxiety that other medicines did not control. It is a conventional antipsychotic. It reduces abnormal excitement in the brain. Do not use it in children younger than 2 years or who weigh less than 20 pounds (about 9 kilograms).

The DailyMed prochlorperazine maleate tablet label classifies it as an anti-emetic and antipsychotic phenothiazine. Each tablet contains the maleate salt equivalent to 5 mg or 10 mg of prochlorperazine. DEA schedule: none.

StatPearls (updated August 14, 2023) describes it as a first-generation antipsychotic that mainly blocks D2 dopamine receptors and also hits histaminergic, cholinergic, and noradrenergic receptors. Routes include oral, intramuscular, intravenous, and rectal. Off-label use in emergency migraine care is common; that use is not an FDA indication on the tablet label.

What does prochlorperazine treat?

DailyMed indications:

• Control of severe nausea and vomiting.
• Treatment of schizophrenia.
• Short-term treatment of generalized non-psychotic anxiety. It is not the first drug for most people with that kind of anxiety, because some risks (including tardive dyskinesia) are not shared by common alternatives such as benzodiazepines.

For non-psychotic anxiety, DailyMed says not to go above 20 mg per day or treat longer than 12 weeks. Higher doses or longer courses may cause persistent tardive dyskinesia that can prove irreversible. Effectiveness for this anxiety use came from four-week outpatient studies of generalized anxiety disorder. That evidence does not predict benefit in other settings where anxiety or anxiety-like signs appear (physical illness, organic mental conditions, agitated depression, character pathologies). DailyMed also states prochlorperazine has not been shown effective for behavioral complications in people with mental retardation.

StatPearls lists FDA-labeled use for schizophrenia, schizoaffective illness, and other psychotic presentations, plus nausea and vomiting in post-chemotherapy, post-radiation, and peri-operative settings. It notes migraine as a non-FDA use. The American Headache Society, as cited in that review, has recommended prochlorperazine among first-line emergency medicines for adult migraine. Off-label use needs a clear clinical reason and a discussion of alternatives.

Prochlorperazine is not approved for dementia-related psychosis. Older adults with dementia have a higher death risk on antipsychotics.

MedlinePlus: if you use it for nausea and vomiting, tell the clinician about other symptoms such as listlessness, confusion, seizures, headache, vision or speech change, or severe belly pain. Those signs can point to a problem that this medicine should not mask.

How do you take prochlorperazine?

MedlinePlus: adults usually take tablets three to four times a day. Children usually take them one to three times a day. Suppositories are usually inserted twice a day. Start low. Raise no more often than every 2 to 3 days. For schizophrenia, the medicine controls symptoms; it does not cure the illness. Do not stop suddenly. Abrupt stop can cause nausea, vomiting, dizziness, and shakiness. Taper.

DailyMed adult oral dosing:

• Severe nausea and vomiting: usually one 5 mg or 10 mg tablet 3 or 4 times daily. Daily doses above 40 mg should be used only in resistant cases.
• Non-psychotic anxiety: usual dose 5 mg 3 or 4 times daily. Do not exceed 20 mg per day or 12 weeks.
• Psychotic disorders, milder outpatient course: 5 or 10 mg 3 or 4 times daily.
• Moderate to severe psychosis under close supervision: usual start 10 mg 3 or 4 times daily. Raise in small steps every 2 or 3 days. Some people respond on 50 to 75 mg daily. In more severe illness, optimum daily dose is often 100 to 150 mg.
• Elderly or debilitated patients: stay in the lower range. Raise more slowly. Watch for hypotension and neuromuscular reactions.

StatPearls adult oral summary: nausea 5 to 10 mg every 6 to 8 hours, max 40 mg/day; anxiety 5 to 10 mg every 6 to 8 hours, max 20 mg/day for 12 weeks; schizophrenia 5 to 10 mg every 6 to 8 hours, titrate, max 150 mg/day. Rectal: 25 mg every 12 hours for severe nausea. Injectable 5 mg/mL products are for clinic or hospital use, not a home video visit.

DailyMed pediatric oral nausea table (do not use under 2 years or under 20 lb; do not use in pediatric surgery):

• 20 to 29 lb: 2.5 mg 1 or 2 times a day; max 7.5 mg per day.
• 30 to 39 lb: 2.5 mg 2 or 3 times a day; max 10 mg per day.
• 40 to 85 lb: 2.5 mg 3 times a day or 5 mg 2 times a day; max 15 mg per day.

Pediatric psychosis (ages 2 to 12): start 2.5 mg 2 or 3 times daily. Do not give more than 10 mg the first day. Ages 2 to 5: usual daily total does not exceed 20 mg. Ages 6 to 12: usual daily total does not exceed 25 mg.

Missed dose (MedlinePlus): take it when you remember unless the next dose is near. Do not double up.

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What side effects should you watch for?

Common effects from MedlinePlus include dizziness or unsteadiness, blurred vision, dry mouth, stuffed nose, headache, nausea, constipation, trouble urinating, pupil size change, increased appetite or weight, agitation or insomnia, blank face, drooling, tremor, shuffling walk, breast enlargement or milk production, missed periods, and lower sexual function in men.

Serious effects that need urgent care:

• Neuroleptic malignant syndrome pattern: fever, stiff muscles, confusion, sweating, fast or irregular heartbeat.
• Tardive dyskinesia: fine worm-like tongue movements or rhythmic face, mouth, or jaw movements.
• Acute dystonia: neck cramps, tongue that sticks out, throat tightness, trouble breathing or swallowing.
• Seizures, falls, yellowing of skin or eyes, infection signs, rash or swelling that suggests allergy, prolonged erection, night vision loss or brown-tinted vision, coma.

DailyMed boxed warning: older adults with dementia-related psychosis have a higher death risk on antipsychotics. Analyses of 17 placebo-controlled trials (about 10 weeks) showed death risk about 1.6 to 1.7 times placebo; roughly 4.5% vs 2.6%. Most deaths were cardiovascular or infectious. Prochlorperazine is not approved for dementia-related psychosis. MedlinePlus repeats that warning.

DailyMed also warns that extrapyramidal symptoms can look like a primary brain illness that is causing the vomiting, including Reye’s syndrome. Avoid this drug and other potential liver toxins in children and teens whose picture suggests Reye’s. Children with chickenpox, measles, gastroenteritis, CNS infection, or dehydration are more prone to dystonia. Use only under close supervision.

MedlinePlus: prochlorperazine can make it harder to cool down in heat. Home pregnancy tests can be unreliable. Do not rely on a home kit. Tell clinicians before a myelogram; the medicine is often held for 2 days before and 1 day after. Late-pregnancy use can cause problems in newborns after delivery.

StatPearls: stop if ANC falls below 1,000, and consider stopping if the white count drops without a clear reason. Rare risks include agranulocytosis, cholestatic jaundice, and QTc change.

Who should not take prochlorperazine?

DailyMed contraindications:

• Known hypersensitivity to phenothiazines.
• Comatose states or large amounts of CNS depressants (alcohol, barbiturates, narcotics).
• Pediatric surgery.
• Pediatric patients under 2 years or under 20 lb, or any pediatric use without an established dose.

MedlinePlus also flags extra caution for glaucoma, balance problems, seizures, abnormal EEG, brain damage, pheochromocytoma, breast cancer, bone-marrow problems, heart disease, planned work with organophosphorus insecticides, tartrazine or aspirin allergy (some tablets), and prior severe reactions to psychiatric medicines. Alcohol can worsen sedation. Do not drive until you know how you react. Stand up slowly.

Overdose (MedlinePlus): agitation, insomnia, blank face, drooling, tremor, shuffling walk, sleepiness, coma, seizures, irregular heartbeat, fever, dry mouth, constipation. Poison control: 1-800-222-1222. Collapse, seizure, or trouble breathing is 911. DailyMed: do not use epinephrine for hypotension; phenothiazines can reverse it. Levophed or Neo-Synephrine are the pressors the label names if a vasoconstrictor is needed.

When is telehealth enough?

A video visit can review nausea, anxiety, or psychosis history, current medicines, movement side effects, and whether a short oral course or a different option fits. A remote clinician cannot give an IM or IV dose, insert a suppository for you, or run an ECG or CBC in the visit itself. Labs and shots still happen at a clinic, lab, or hospital.

Telehealth is a poor fit when vomiting is paired with neurologic red flags, when a child is under 2 or dehydrated, when NMS or dystonia appears, or when someone cannot keep fluids down. Those need in-person or emergency care.

HHS telehealth policy (updated February 5, 2026): Medicare patients can permanently receive behavioral health telehealth in the home. An in-person visit within six months of an initial Medicare behavioral telehealth service is not required through December 31, 2027.

Klarity Health has 2,000+ licensed providers. Many visits happen online. Coverage varies by plan. Verify benefits before you book. This is not a promise that prochlorperazine will be prescribed or that any insurer will pay for it.

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Insurance and next steps

Many commercial and Medicare plans may cover a telehealth mental health visit and, separately, a generic antiemetic or antipsychotic after formulary rules. Coverage varies by plan, state, and pharmacy tier. Ask the plan about prior authorization before you assume a fill will go through.

If you or someone you know is in crisis, call or text 988 or chat at 988lifeline.org.

Disclaimer: This article is for education. It is not medical advice, a diagnosis, or a guarantee of insurance coverage. Talk with a licensed clinician about your own care. Coverage varies by plan. Verify benefits before booking.