Brain & Nervous System Migraines Treatment Print Compazine for Migraine Therapy A treatment for migraine-associated nausea, vomiting, and other symptoms Medically reviewed by Medically reviewed by Claudia Chaves, MD on February 13, 2019 Claudia Chaves, MD is board-certified in cerebrovascular disease and neurology, with a subspecialty certification in vascular neurology. Learn about our Medical Review Board Claudia Chaves, MD Written by linkedin Written by Teri Robert Teri Robert is a writer, patient educator, and patient advocate focused on migraine and headaches. Learn about our editorial policy Teri Robert Updated on June 24, 2019 Migraine Overview Symptoms Causes Diagnosis Treatment Prevention Coping In This Article Table of Contents Expand Uses How It Works Dosing/Formulation Side Effects Interactions Who Shouldn't Take It View All Compazine (prochlorperazine) is an prescription-strength antiemetic and antipsychotic approved for the treatment of severe nausea and vomiting, schizophrenia, and generalized non-psychotic anxiety. It is also used to relieve migraine-associated nausea and vomiting, as well as other symptoms of migraine attacks and tension headaches, particularly in the emergency setting. Uses Prochlorperazine is one of the first-line recommended treatments for severe migraine episodes in the emergency setting because it is effective in reducing the symptoms of migraines and headaches, comes in many formulations, and works quickly. However, it is not used for migraine or headache prevention and is rarely given as a prescription for these conditions on a regular, long-term basis. Prochlorperazine is recommended for medication rebound or overuse headaches, intractable headaches, status migrainosus, and for headaches and migraines in which severe nausea and vomiting are the predominant symptoms. It is also considered among the most effective medications for severe childhood migraines, with and without nausea. Medications That Cause Overuse Headaches Compazine is not an opioid, and it is not addictive. Recent studies have shown that it is at least as effective, if not more so, than opioids, which are fast acting, but highly addictive medications used for the treatment of severe pain. How It Works The anti-headache and anti-migraine mechanisms of Compazine are not well understood, but the drug's effectiveness seems to be tied to its influence on dopamine—a neurotransmitter that acts on the brain (to modulate muscle movement, emotions, and pain) and the body (affecting gastrointestinal activity and muscle movement). As a phenothiazine-derived antipsychotic, Compazine is a dopamine receptor antagonist, which means that it inhibits activity of this neurotransmitter. Researchers suggest that people who have migraines may be hypersensitive to dopamine and that prochlorperazine could reduce migraine and headache symptoms by modifying the neurotransmitter's effects, which have been implicated as a cause of nausea and vomiting. The drug is believed to act both centrally (in the brain) and systemically (throughout the body, especially the digestive system). Dosing and Formulation Compazine is available in several forms. What's best for you will be determined by your doctor based on the severity of your symptoms, your ability to keep things down, and more. Options include: Oral (by mouth): Available in 5 mg and 10 mg tablets, sustained release 10 mg and 15 mg capsules, and as a liquid. The suggested oral dose for treatment of migraines and headaches in adults is 5 mg or 10 mg, which can be repeated every six to eight hours.Suppository (inserted rectally): Available in 2.5 mg, 5 mg, and 25 mg doses. The adult suppository dose is typically 25 mg for an acute migraine attack, and the maximum recommended dose is twice per day.Injections: Intravenous (injected into a vein, IV) and intramuscular (injected into a muscle, IM) injections can range between 2.5 mg and 10 mg, with a maximum recommended dose of 40 mg per day. In Children Compazine is not recommended for children younger than age 2 or who are under 20 pounds. For older children, the recommended dose for treatment of migraines and other headaches is 2.5 mg orally or rectally. IM an IV administration is not common for children, and the dose is determined on a case-by-case basis. Side Effects There are side effects associated with Compazine, but they are usually associated with chronic use. However, in some rare instances, serious adverse events can occur even after only a single dose of the medication. Side effects can include: DrowsinessLow blood pressureDizzinessAmenorrhea (slowing or stopping of menstrual periods)Blurry visionAkathisia (physical restlessness) Side Effects of Prochlorperazine Complications Long-term use of Compazine can trigger parkinsonism, which is characterized by the same symptoms as Parkinson's disease. It can also trigger tardive dyskinesia, which is characterized by: Lip smacking or puckeringMuscle spasms of face, neck, body, arms, or legs, causing unusual body positions or unusual expressions on the faceRapid or worm-like movements of the tongueTic-like or twitching movements Compazine may cause neuroleptic malignant syndrome (NMS)—a potentially fatal condition characterized by muscle rigidity, an elevated body temperature, confusion, and dysregulation of the autonomic nervous system. Interactions Compazine can interact with other medications that make you sleepy or drowsy. Be sure to make your prescribing doctor aware of any medications, prescription or over-the-counter, and supplements that you take. Contraindications You should not use Compazine if you have an allergy or sensitivity to phenothiazines. You also should not use it if you have low blood pressure, heart problems, or motor problems such as Parkinson's disease, dystonia, or spasms. It is not known whether Compazine will harm an unborn baby. If you have already used Compazine in the past and have the medication at home, it's important to consult your doctor before taking it if you are pregnant or if you are planning on becoming pregnant. While Compazine is sometimes used during pregnancy with caution, it is not recommended for breastfeeding mothers. A Word From Verywell While not a typical at-home prescription therapy for headaches and migraines, Compazine is sometimes given in the emergency room. If you have severe nausea with your headaches, or if status migrainosus or medication rebound headaches are recurrent problems for you, talk to your doctor about a migraine treatment plan so that you can avoid these distressing events. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Friedman B, Monteith T. Despite Variations, Evidence Provides Clear Road Map for Adult Patients Presenting with Acute Migraine. ED Manag. 2017 Mar;29(3):31-33. Friedman BW, Irizarry E, Solorzano C, et al. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology. 2017 Nov 14;89(20):2075-2082. doi: 10.1212/WNL.0000000000004642. Epub 2017 Oct 18. Sheridan DC, Laurie A, Pacheco S, et al. Relative Effectiveness of Dopamine Antagonists for Pediatric Migraine in the Emergency Department. Pediatr Emerg Care. 2018 Mar;34(3):165-168. doi: 10.1097/PEC.0000000000000718. Continue Reading