Aminophylline
Contraindicated
Textbook
Should not be mixed in the same infusion bottle/syringe.
Do not mix.
Source: KDT 7e · p227
Drug reference
Chlorpromazine
Typical (first-generation) phenothiazine antipsychotic · Antipsychotic
Also known as Chlorpromazine Hydrochloride, CPZ, Thorazine, Largactil
START
Baseline ECG (QTc), LFTs, CBC. Check for CYP2D6 poor metabolizer status if available. Assess falls risk (elderly).
TYPICAL MAX
2000mg/day. Avoid exceeding 1000mg/day in elderly. EPS and sedation are dose-limiting.
STOP IF
NMS (fever, rigidity, autonomic instability), QTc >500ms, agranulocytosis, neuroleptic-induced jaundice, severe TD.
WATCH
EPS—monitor with AIMS (abnormal involuntary movement scale) for TD. Orthostatic BP (especially elderly). Photosensitivity—counsel sun protection. Anticholinergic burden in elderly. Do not stop abruptly—withdrawal dyskinesia risk.
CDSCO approvedSchedule HJan AushadhiNPPA price-controlledATC N05AA01
KDIGO 2024 + manufacturer label
- ONSET
- 1h · Onset 30-60 min (PO)
- PEAK
- 3h · Tmax 2-4 hours
- t½
- 1.3d · t½ ~30 hours
- DURATION
- 6h · 4-6 hours per dose
EXCRETION
Renal as metabolites (~80%)
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Crosses placenta; may cause extrapyramidal symptoms and withdrawal in neonates if used near term. Use only if benefit outweighs risk.
FDA category + note
Top interactionssee all 12 →
- AminophyllineContraindicatedTextbookKDT 7e · p227
- CodeineSevereTextbook-citedKDT 7e · p950
- DiazepamSevereTextbook-citedKDT 7e · p950
- MorphineSevereTextbook-citedKDT 7e · p950
Available in India
67 branded formulations and 59 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Non-selective dopamine D2 receptor antagonism (mesolimbic pathway = antipsychotic effect; nigrostriatal = EPS; tuberoinfundibular = hyperprolactinemia). Also blocks α1-adrenergic, muscarinic, and histamine H1 receptors.
Indications
Schizophrenia and other psychotic disordersBipolar disorder (acute mania)Severe behavioral problems in childrenIntractable hiccupsNausea and vomiting (intractable)Acute intermittent porphyriaPreoperative sedation
Dosing
- Adult
- Psychosis: 25mg PO TID initially, increase gradually to 400-800mg/day (max 2000mg/day). Acute agitation: 25-50mg IM/IV, may repeat. Hiccups: 25-50mg PO TID-QID. Nausea: 10-25mg PO/IM q4-6h PRN.
- Pediatric
- Psychosis (≥6 months): 0.5mg/kg PO q4-6h or 0.5-1mg/kg IM q6-8h. Max 40mg/day (1-5 years); 75mg/day (5-12 years).
- Renal adjustment
- Use caution; start with lower doses.
- Hepatic adjustment
- Reduce dose by 50% in hepatic impairment; avoid in severe liver disease.
- Geriatric
- Start 10-25mg PO BID-TID; increased sensitivity to sedation, hypotension, EPS, and anticholinergic effects.
- Max dose
- 2000mg/day (adults); 75mg/day (children 5-12 years)
Pharmacokinetics
Onset
PO: 30-60 minutes; IM: 15-30 minutes; IV: immediate
Peak effect
PO: Tmax 2-4 hours; IM: peak in 1-2 hours
Duration
4-6 hours (PO); 4-8 hours (IM)
Half-life
~30 hours (range 18-30h); active metabolites prolong effect
Bioavailability
~10-33% (extensive first-pass metabolism)
Protein binding
95-98%
Metabolism
Extensive hepatic via CYP2D6 (major), CYP1A2, CYP3A4; many active metabolites including 7-hydroxychlorpromazine
Excretion
Metabolites primarily renal (~80%); some biliary
Contraindications
- Coma or severe CNS depression
- Concurrent use of large doses of CNS depressants
- Severe hepatic or cardiovascular disease
- Blood dyscrasias
- Pheochromocytoma
- QT prolongation / congenital long QT syndrome
Side effects
Common
SedationOrthostatic hypotensionDry mouthConstipationBlurred vision (anticholinergic)Urinary retentionWeight gain
Serious
- Neuroleptic malignant syndrome (NMS)
- Tardive dyskinesia
- Severe extrapyramidal symptoms (dystonia, akathisia, parkinsonism)
- QT prolongation / torsades de pointes
- Agranulocytosis
- Cholestatic jaundice
- Seizures (lowers seizure threshold)
Pregnancy & lactation
Pregnancy
Crosses placenta; may cause extrapyramidal symptoms and withdrawal in neonates if used near term. Use only if benefit outweighs risk.
Lactation
Excreted in breast milk; may cause drowsiness and EPS in infant. Use lowest effective dose; consider alternative antipsychotic.
Drug interactions
Codeine
Severe
Textbook-cited
Enhanced sedation and respiratory depression.
Avoid concurrent use
Source: KDT 7e · p950
Diazepam
Severe
Textbook-cited
Excessive sedation, respiratory depression, motor impairment.
Avoid concurrent use
Source: KDT 7e · p950
Morphine
Severe
Textbook-cited
Excessive sedation and respiratory depression; potentially fatal.
Avoid concurrent use
Source: KDT 7e · p950
Pethidine
Severe
Textbook-cited
Severe sedation and respiratory depression
Avoid concurrent use
Source: KDT 7e · p950
Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Aminolevulinic Acid
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amiodarone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amisulpride
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arsenic Trioxide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bedaquiline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about Chlorpromazine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19