Taking Compazine for Migraine Therapy

Dosage and Possible Side Effects

man holding his head in pain in a waiting room
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Compazine (prochlorperazine) is commonly utilized in the treatment of nausea and vomiting, migraines, and even tension headaches in the emergency room.

Compazine is a phenothiazine-derived drug, which means it's an antipsychotic. It's available as either a tablet, an extended-release capsule, injection, or rectal suppository. A common dosage in the emergency room is 25mg by mouth or suppository, with a maximum of three doses over 24 hours. 

What You Should Tell Your Doctor Before Taking Compazine

It's important to disclose your complete medical history to your doctor, including any medications, over-the-counter supplements, or vitamins you are taking. Some people should not take Compazine — like those who have a history of an allergy or sensitivity to phenothiazines, or people who are taking other medications that may depress their central nervous systems, like butalbital-containing headache medications.

Side Effects

There are a number of possible side effects associated with Compazine. According to a 2002 article in American Family Physician, adverse reactions may include:

Types of Movement Problems Seen With Compazine

Compazine can cause involuntary movements, due to the blockage of certain dopamine receptors. These movements may include restlessness, agitation, spasm of neck muscles, Parkinson-like symptoms, and tardive dyskinesia.

Symptoms of tardive dyskinesia include:

  • inability to move eyes
  • lip smacking or puckering
  • muscle spasms of face, neck, body, arms, or legs, causing unusual body positions or unusual expressions on face
  • puffing of cheeks
  • rapid or worm-like movements of tongue
  • sticking out of tongue
  • tic-like or twitching movements
  • trouble in breathing, speaking, or swallowing
  • uncontrolled chewing 

Rarely, Compazine may cause neuroleptic malignant syndrome — a potentially fatal condition characterized by symptoms like muscle rigidity, an elevated body temperature, confusion, and dysregulation of the autonomic nervous system

Taking Compazine While Pregnant or Breastfeeding

  • It is not known whether Compazine will harm an unborn baby. It's important to not take Compazine while pregnant or if planning on becoming pregnant without first consulting your doctor.
  • Compazine passes into breast milk and may affect a nursing baby — so it's important to not take Compazine without first talking to your doctor if you are breastfeeding.

Bottom Line

Compazine is an effective therapy for mild to moderate migraines, and its benefit is best when given as early in the attack as possible. While not a typical home therapy, it is sometimes given in the emergency room. If you have any questions or concerns prior to taking Compazine, please speak with your doctor.

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Article Sources
  • Aukerman G & Miser WF. Management of the Acute Migraine Headache. Am Fam Physician. 2002 Dec 1;66(11):2123-31.
  • DeMaagd G. Overview and Abortive Therapy. The Pharmacological Management of Migraine, Part 1. PT. 2008 Jul;33(7):404-16.
  • FDA. Compazine.