prochlorperazine maleate / Generic mfg. - LARVOL DELTA

P091 Posterior reversible encephalopathy syndrome (PRES) presenting in a patient with psoriasis receiving ustekinumab. (PubMed, Br J Dermatol) - P3 | "Prochlorperazine 5 mg three times daily and amlodipine 10 mg once daily were commenced and ustekinumab suspended...PRES has been described in patients using adalimumab, infliximab and ustekinumab, most commonly in the context of inflammatory bowel disease...However, it is important that clinicians are aware of this rare debilitating neurological adverse event, so prompt withdrawal of possible triggers including biologic agents can be made to facilitate neurological recovery. The half-life of ustekinumab is problematic for prompt withdrawal and there remain questions regarding ongoing management of the patient's inflammatory dermatosis and arthritis, as case reports document worsening of PRES on reintroduction of traditional immunosuppressive systemic agents."

Journal • Cardiovascular • CNS Disorders • Dermatology • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Hypertension • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Pain • Psoriasis • Psoriatic Arthritis • Rheumatology • Seronegative Spondyloarthropathies

High-Throughput Screening Using the Self-Controlled Tree-Based Scan Statistic to Identify Medications Associated With Hospitalization for Severe Acute Liver Injury. (PubMed, Pharmacoepidemiol Drug Saf) - "High-throughput screening using tree-based scan statistics detected potentially hepatotoxic drugs for investigation in future pharmacoepidemiology studies."

Journal • CNS Disorders • Gastroenterology • Hepatology • Liver Failure • Pain

Large-scale integration of omics and electronic health records to identify potential risk protein biomarkers and therapeutic drugs for cancer prevention. (PubMed, Am J Hum Genet) - "Analyzing >3.5 million electronic health records, we conducted analyses of emulated trials for 11 drugs across 290 comparisons and identified three drugs significantly associated with reduced colorectal cancer risk: caffeine vs. paroxetine (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.41-0.64), haloperidol vs. prochlorperazine (HR, 0.47; 95% CI, 0.33-0.68), and trazodone hydrochloride vs. paroxetine (HR, 0.49; 95% CI, 0.38-0.63). Conversely, caffeine was associated with increased cancer risk in comparison with finasteride (colorectal cancer) and fluoxetine (breast cancer). Meta-analysis identified six drugs significantly associated with cancer risk, including acetazolamide, which was associated with reduced colorectal cancer risk (HR, 0.79; 95% CI, 0.72-0.87). This study identifies previously unreported protein biomarkers and candidate drug targets across six major cancer types and highlights several approved drugs with potential chemopreventive effects."

Biomarker • Journal • Breast Cancer • Colorectal Cancer • Genito-urinary Cancer • Oncology • Pancreatic Cancer • Prostate Cancer • Solid Tumor

2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. (PubMed, Headache) - "Prochlorperazine IV and GONB must be offered to eligible adults presenting to the ED with a migraine attack for treatment of headache requiring parenteral therapy (level A - must offer) in those without contraindications, while hydromorphone IV must not be offered (level A - must not offer). Treatments that should be offered when appropriate (level B - should offer) include dexketoprofen IV, ketorolac IV, metoclopramide IV, sumatriptan SC, and SONB. Chlorpromazine IV, dexamethasone IV, and valproate IV may be offered (level C - may offer). Paracetamol IV may not be offered (level C - should not offer). Eptinezumab should be offered (level B) only for patients matching the clinical trial population but is rated level U - no recommendation for an ED-specific population. Additional evidence is needed for caffeine, granisetron, ibuprofen, ketamine, lidocaine, normal saline, propofol, and SPG blocks, all currently rated level U - no recommendation."

Journal • CNS Disorders • Migraine • Pain

Rimegepant for acute treatment of atypical headache syndromes: A case series (EHF-EHC 2025) - "The migralepsy patient became resistant to NSAIDs; the FHM patient had limited, inconsistent response to prochlorperazine and ketorolac, and no benefit from NSAIDs, dexamethasone, acetazolamide, or IV magnesium sulfate. Further studies are needed to confirm these findings. Patients gave their consent to publish their details in an open access journal."

Clinical • CNS Disorders • Migraine • Mood Disorders • Pain

Preoperative Aprepitant Decreases Postoperative Nausea After Laparoscopic Sleeve Gastrectomy. (PubMed, R I Med J (2013)) - "The addition of preoperative aprepitant to a multimodal protocol can reduce nausea after laparoscopic sleeve gastrectomy."

Journal • Retrospective data • Gastrointestinal Disorder

Involvement of KCC2-dependent chloride extrusion in the use and effects of drugs of abuse: a scoping review (Neuroscience 2025) - "We found that expression patterns of KCC2 were significantly impacted by various potentially abusable drugs, including morphine, remifentanil, ethanol, diazepam, zolpidem, memantine, phenobarbital, pentylenetetrazol, nicotine, cannabinoids, methamphetamine, prochlorperazine, TCB2, propofol, isoflurane, and sevoflurane, though some reports varied on the directionality of that expression change with specific drugs. These results suggest a strong connection between KCC2 and drugs of abuse. This work advances KCC2 as a potential drug target for treatment of substance use disorders and highlights areas of interest for future work."

Review • Addiction (Opioid and Alcohol) • CNS Disorders • Epilepsy

Identifying Terminologies Used Prior to the Onset of Interstitial Lung Disease in Patients With Lung Cancer: Descriptive Analysis of Electronic Medical Record Data. (PubMed, JMIR Cancer) - "In the 30 days prior to ILD onset, notable differences in word frequencies per 1000 notes between the ILD-GC Set and No ILD Set were observed in the following term categories: respiratory symptoms (eg, breathlessness, shortness of breath, oxygen), ranging from 170.59 to 46.51; pain or analgesics (eg, Lyrica [pregabalin], soreness, precordial pain, opioids), ranging from 462.88 to 45.16; and appetite-related terms (eg, inappetence, food intake, queasiness, Novamin [prochlorperazine]), ranging from 102.23 to 51.90. Terms related to respiratory symptoms, pain or analgesics, and appetite were identified as associated factors for ILD onset in patients with stage IV lung cancer using RWD from acute care institutions for malignant tumors. These findings may support the early detection of ILD and underscore the potential of RWD to generate real-world evidence that informs drug discovery and pharmaceutical development."

IO biomarker • Journal • Infectious Disease • Interstitial Lung Disease • Lung Cancer • Oncology • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Comparative Analysis of Medication Use and Healthcare Utilization in Gastroparesis and Functional Dyspepsia: A Propensity-Matched Cohort Study (ACG 2025) - "We identified 7,329 patients with GP (mean age 47.1±17.6 years; 72.7% female) and 3,950 with FD (mean age 44.7±20.3 years; 69.2% female). After 1:1 matching, 3,420 patients per group were followed for 5 years. GP patients had significantly higher use of metoclopramide (RR 3.4, 95% CI 3.02–3.84, P-value< .0001), erythromycin (RR 2.7, 95% CI 2.24–2.92, P-value< .0001), and antiemetics including ondansetron, promethazine, prochlorperazine, and diphenhydramine (all P-value< .0001)."

HEOR • Dyspepsia • Gastrointestinal Disorder

The Nausea Atlas: Identifying and Characterizing Nausea Subtypes Using Patient-Reported Information (ACG 2025) - "Ondansetron was the most effective anti-nausea medication, followed by promethazine, lorazepam, prochlorperazine, and domperidone. Marijuana was the most effective non-medication treatment, outperforming dronabinol... 745 participants (77% Female; 19% Male), reporting 1200 distinct nausea types/experiences were evaluated. The most represented age range was 31–40 years. 22% of respondents reported their nausea as severely or completely debilitating."

Clinical • Gastrointestinal Disorder • Mood Disorders • Psychiatry

Dystonia in a Dose: Recognizing a Class Effect in Susceptible Patients (ACG 2025) - "This case report describes a young patient who has extrapyramidal side effects to multiple anti-emetics (metoclopramide, promethazine, and prochlorperazine), all of which triggered dystonic reactions, rendering only trimethobenzamide and ondansetron as viable treatment options.Case Description/ A 32-year-old male was admitted to hospital with viral gastroenteritis due to coronavirus infection...The healthcare team promptly responded, and given characteristic dystonic presentation, prior history of dystonia with other medications, and temporal relation with metoclopramide administration, the reaction was identified as a medication-induced extrapyramidal side effect and diphenhydramine was administered...This case emphasizes the need for healthcare providers to be vigilant and proactive when choosing antiemetic agents, particularly for patients with a history of extrapyramidal symptoms. Further research into strategies to prevent medication-related adverse effects,..."

Clinical • CNS Disorders • Dystonia • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Movement Disorders • Novel Coronavirus Disease • Respiratory Diseases

A Rare Cause of Nausea and Vomiting in Pregnancy: Achalasia (ACG 2025) - "She was given intravenous fluids, metoclopramide, famotidine, diphenhydramine, ondansetron, famotidine, pantoprazole and prochlorperazine with minimal improvement. This patient had very common symptoms but a rare diagnosis and an extremely unfortunate outcome. It is therefore of the utmost importance to always keep a broad differential when assessing pregnant females with common complaints."

Asthma • Gastrointestinal Disorder • Immunology • Rare Diseases • Respiratory Diseases

Advanced Practice Provider-Led Outpatient Lymphodepleting Chemotherapy Administration for Patients Receiving Tumor-Infiltrating Lymphocyte Therapy for the Treatment of Advanced Melanoma (JADPRO 2025) - "Introduction / Background In February 2024, lifileucel became the first FDA-approved adoptive cell therapy for the treatment of any solid tumor and was specifically approved to treat advanced melanoma. The package insert specifies a lymphodepleting (LD) chemotherapy regimen of cyclophosphamide 60 mg/kg IV with mesna for 2 days, followed by fludarabine 25 mg/m2 IV for 5 days before cell infusion...Infection prophylaxis: • Acyclovir - Start on Day -7...Olanzapine-Start on Day -8 at bedtime & continue nightly for up to one week...Ondansetron - Day -7 through Day -3 as pre-medication to chemotherapy...Prochlorperazine - Prescription provided for breakthrough nausea...It will be essential to better define the training for APPs in solid tumor cellular therapies. Continued exploration of APP-led outpatient models may reduce hospital stays, improve patient outcomes and satisfaction, and lower healthcare costs-benefiting not only melanoma patients but potentially those with..."

Clinical • Metastases • Tumor-infiltrating lymphocyte • Hematological Disorders • Infectious Disease • Melanoma • Oncology • Solid Tumor

A RARE CASE OF PNEUMOMEDIASTINUM SECONDARY TO DIABETIC KETOACIDOSIS (CHEST 2025) - "He was also given intravenous piperacillin/tazobactam for the elevated leukocytes raising possible concern for infection secondary to the pneumomediastinum. Intravenous prochlorperazine was administered to control the vomiting...Intravenous famotidine was administered for peptic ulcer prophylaxis... Despite the patient's serious presentation, early management of his DKA helped him avoid any long-term sequelae of his pneumomediastinum."

Clinical • Diabetes • Gastroenterology • Infectious Disease • Metabolic Disorders • Mood Disorders • Peptic Ulcer • Pneumonia • Pulmonary Disease • Respiratory Diseases • Type 1 Diabetes Mellitus • Type 2 Diabetes Mellitus

The off-label use of psychotropic medicines in paediatric patients in Australian primary care. (PubMed, Psychiatry Res) - "Psychotropic medicines were defined by the Anatomical Therapeutic Chemical Classification codes N05 (Psycholeptics) and N06 (Psychoanaleptics), except for prochlorperazine...A total of 1650 psychotropic medicines were prescribed, with sertraline (14.55 %), fluoxetine (12.48 %), methylphenidate (9.27 %), diazepam (5.52 %), and citalopram (5.27 %) being the most common...Off-label psychotropic medicine use in paediatric patients is common in Australian primary care, with most OLU classified as age-based rather than indication-based. These findings demonstrate high off-label rates and, given limited paediatric evidence, underscore the need for targeted guidelines, enhanced prescriber education, and further research to improve safe and effective use in this population."

Journal • CNS Disorders • Pediatrics

Novel presentation of PRRT2 with paroxysmal dystonia and responsive to carbidopa/levodopa. (MDS Congress 2025) - "Dystonic symptoms improved in the emergency department with diazepam and methocarbamol. PRRT2 PKD is classically treated with carbamazepine. In this novel case, a patient with PKD developed overt hemi-dystonia after treatment with prochlorperazine. This is a novel presentation and is postulated to have unmasked episodic dystonic symptoms."

CNS Disorders • Dystonia • Migraine • Movement Disorders

INTRAVENOUS TREATMENTS FOR HEADACHE DISORDERS (WCN 2025) - "In some places, ketorolac is favoured, elsewhere chlorpromazine or prochlorperazine and there are several other options such as aspirin and valproate...The agents most often used include dihydroergotamine (DHE), lidocaine and ketamine...Recently, a CGRP antibody given intravenously for migraine prophylaxis has become available: eptinezumab...DHE has at times been used in cluster headache. Some of the evidence for these treatments and some practical advice about them will be discussed."

CNS Disorders • Migraine • Pain

Dexmedetomidine for Reducing Perioperative Nausea and Vomiting in Cesarean Delivery (ASA 2025) - "Inclusion criteria were >37 weeks gestational age, cesarean delivery, and use of ondansetron and dexamethasone on the same day of surgery...Risk analysis and Kaplan-Meier survival analysis were performed to assess the outcome of intraoperative and perioperative nausea and vomiting by the use of rescue antiemetics (droperidol, promethazine, dimenhydrinate, metoclopramide, prochlorperazine)... Contrary to consistent current research findings, dexmedetomidine use was not associated with a reduced incidence of PONV in cesarean delivery patients. This finding suggests that dexmedetomidine may not have the added benefit of reducing PONV in this population. Further prospective studies are needed to confirm these results and explore the underlying mechanisms."

Anesthesia • Diabetes • Gastroesophageal Reflux Disease • Genetic Disorders • Gynecology • Metabolic Disorders • Obesity

Hypotension, Non-Steroidal Anti-Inflammatory Drugs, and Acute Kidney Injury: A Pediatric Case Report (AAP-NCE 2025) - "She was treated with five doses of a migraine cocktail (diphenhydramine, prochlorperazine, and ketorolac) and empiric antibiotics (including four doses of vancomycin) over the initial 24 hours of hospitalization...She was transferred to the PICU where she was treated with vasopressors, fluid resuscitation, and antibiotics, as well as methylprednisolone and intravenous immunoglobulin... The association of hypotension along with failure of renal afferent arteriolar vasodilation suggests the need for caution with repeated doses of this migraine cocktail. This case highlights the combined risk of prochlorperazine, diphenhydramine, and ketorolac, and the summative impact of nephrotoxic medications in a previously healthy patient."

Case report • Clinical • Acute Kidney Injury • CNS Disorders • Hypotension • Inflammation • Migraine • Nephrology • Pediatrics • Renal Disease • CRP

MAGraine2: Effectiveness of Magnesium in Addition to Prochlorperazine for the Treatment of Migraines (clinicaltrials.gov) - P3 | N=100 | Not yet recruiting | Sponsor: Wake Forest University Health Sciences | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial primary completion date • CNS Disorders • Migraine • Pain

Cannabinoid Hyperemesis Syndrome Treated With Fosaprepitant: A Case Report. (PubMed, Cureus) - "The usual treatment options for nausea and vomiting include fluids and a combination of metoclopramide, ondansetron, promethazine, or prochlorperazine. We present a case where fosaprepitant was utilized for intractable nausea and vomiting when other treatment modalities failed for CHS."

Journal

Response to intravenous dihydroergotamine (DHE) for the treatment of refractory chronic migraine in adolescent patients (IHC 2025) - "Pre-infusion ondansetron 150 mcg/kg and prochlorperazine 5 mg/kg were administered PRN...For management, 54% (14/26) used sumatriptan,19% (5/26) used rizatriptan, 23% (6/26) used zolmitriptan, and 4% (1/26) used eletriptan. Preventively, 31% (8/26) had used propranolol, 23% (6/26) topiramate, 23% (6/26) amitriptyline, and 23% (6/26) pizotifen...This may include infusion slowing and increasing anti-emetic breadth and doses. Larger longer-term follow up studies are needed."

Clinical • CNS Disorders • Migraine

Vestibular migraine attacks treated with remote electrical neuromodulation (IHC 2025) - "In practice, neuro-otologists typically prescribe vestibular sedatives like prochlorperazine, which are not always well tolerated...Conclusion REN may be an option for the acute treatment of vestibular migraine. Our preliminary experience suggests that the benefit could be more pronounced when patients describe internal vertigo."

CNS Disorders • Migraine

Emesis and Constipation Induced by Methadone and the Active Metabolite of Tramadol (M1) in Animals. (PubMed, J Appl Toxicol) - "In contrast to previous findings with morphine, M1-induced retching was significantly inhibited by the selective dopamine D2 receptor antagonist prochlorperazine, but not by the atypical antipsychotic olanzapine, suggesting a distinct receptor-specific modulation. Recognizing these distinct profiles is essential for evaluating opioid-induced adverse effects and can help refine clinical strategies. Ultimately, these insights may contribute to the development of evidence-based interventions aimed at minimizing opioid-related complications and improving the quality of life for patients receiving opioid-based pain therapies."

Journal • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Movement Disorders • Pain • DRD2

Morbidity and Mortality of Ondansetron in Patients with Non-congenital Long QT Syndrome: A Review Article. (PubMed, Cardiovasc Drugs Ther) - "Selective antagonists like ondansetron, granisetron, and tropisetron treat chemotherapy and post-surgical nausea, while non-selective antagonists include metoclopramide and prochlorperazine. This risk has led to FDA dosing recommendations and an emphasis on cardiac monitoring, particularly in patients with predisposing factors such as electrolyte imbalances, cardiac conditions, or concurrent QT-prolonging drugs. This review explores the underlying mechanisms of QT-interval prolongation associated with the selective 5-HT3 receptor antagonist ondansetron, evaluates its impact on morbidity and mortality in at-risk populations, and discusses risk mitigation strategies."

Journal • Review • Cardiovascular