The Safety of Prochlorperazine in Children: A Systematic Review and Meta-Analysis

Abstract

The most common AEs reported with the pediatric use of prochlorperazine are EPS and sedation. Fatalities, life-threatening, and persistent AEs have also been reported.

Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy‐Induced Nausea and Vomiting in Children With Cancer

“…The guideline recommendations are summarized in Table and Supplementary Table SVII. Studies evaluating ABH gel, 5‐HT3 antagonists, and prochlorperazine were included in the evidence summary but were omitted from the recommendations due to poor systemic bioavailability, inclusion as standard acute CINV prophylaxis[11] and safety concerns, respectively.…”

“…Therefore systematic reviews evaluating the safety of metoclopramide [5] and prochlorperazine [6] were undertaken, and an existing systematic review of the safety of olanzapine [7] in children was considered by the panel. Primary studies reported separately for patients ࣘ18 years of age or the mean or median age pf participants was ࣘ18 years; iii.…”

“…The guideline recommendations are summarized in Table I and Supplementary Table SVII. Studies evaluating ABH gel, 5-HT3 antagonists, and prochlorperazine were included in the evidence summary but were omitted from the recommendations due to poor systemic bioavailability, [10] inclusion as standard acute CINV prophylaxis [11] and safety concerns, [6] respectively. Recommendation 1.1: For children receiving acute CINV prophylaxis recommended for minimally, low, or moderately emetogenic chemotherapy (MEC), clinicians should upgrade or escalate the acute CINV prophylaxis provided to that recommended for chemotherapy of the next higher level of emetogenic risk.…”

Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment

“… 26 Phenothiazines and butyrophenones have also been used in CINV, but their use, particularly when administered at a high dose, is limited by the risk of major extrapyramidal reactions (dystonia, parkinsonism and oculogyric crisis). 27 , 28 …”

“…26 Phenothiazines and butyrophenones have also been used in CINV, but their use, particularly when administered at a high dose, is limited by the risk of major extrapyramidal reactions (dystonia, parkinsonism and oculogyric crisis). 27,28 Antagonists of 5-hydroxytryptamine3 (5-HT3) receptors (ondansetron, granisetron, tropisetron, palonosetron) are used in CINV control. 29 Palonosetron is a second-generation 5-HT3 receptor antagonist that has been shown to achieve better control of emesis compared with ondansetron, in children receiving highly or moderately emetogenic chemotherapy over several days.…”