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What Are The Long Term Side Effects Of Prochlorperazine?
Question: PLEASE REPLY ITS URGENT. Would you mind helping me by answering the following? I am so sorry it's so long! I was on the anti emetic Stemetil (Prochlorperazine) for about a year and a half until it started to make my left hand/arm twitch involuntary. In the past I have also tried Cyclizine and Promethazine which didn't help although I'm unsure if I gave them a long enough chance to work - only about a week? Prochlorperazine, Domperidone and Ondansetron (especially the last two) work straight away so that's what I was going on? I also have Domperidone on stand by for bouts of extreme nausea but don't take daily due to cardiac risks on long term use. I have been started on Ondansetron this which is great for the nausea but it's making me severely constipated on top of my constipation which I get from my IBS-C - not good at all and today it's given me a bad headache that I've had all day long. So my doctor has said I could try Buccastem which is a buccal form type of Prochlorperazine which you melt on your upper gum/lip. My doctor said there is less risk of side effects in this form so it probably won't cause the involuntary arm movements but online it says Buccastem isn't meant to be taken for more than two/three days. I'm just uncertain as to what to do for the best anti emetic wise as the long term use side effects of Prochlorperazine which include irreversible tardive dyskinesia (involuntary muscle movements) are scary. Any advice regarding anti emetics which may be helpful in me deciding which ones to try on a long term basis? Which ones do you find most effective on a daily basis and any potential side effects? Thank you so much if you give me any advice it is very much appreciated as I'm just very confused right now!
Brief Answer:
Mosapride or Tegaserod are found to be effective.
Detailed Answer:
Hi & Welcome.
I appreciate your concern for the safety of the drugs prescribed in the treatment of Constipation-Predominant Irritable Bowel Syndrome.
Since long term use of Prochloroperazine is associated with irreversible tardive dyskinesia and drug induced Parkinsonism and the fact that you have developed some sort of tremors in your arm so it not safe to be continued.
Although one of the most effective anti emetics, the use of Ondansetron could result in constipation which may aggravate your symptoms of IBS.
In view of the above, I would suggest you to take either Mosapride or Tegaserod which are found to be effective antiemetic drugs with minimal side effects.
Another option may be Selective serotonin re-uptake inhibitors (SSRIs) which are shown to significantly accelerate intestinal transit and might be useful in your case.
Hope I could answer your query.
Mosapride or Tegaserod are found to be effective.
Detailed Answer:
Hi & Welcome.
I appreciate your concern for the safety of the drugs prescribed in the treatment of Constipation-Predominant Irritable Bowel Syndrome.
Since long term use of Prochloroperazine is associated with irreversible tardive dyskinesia and drug induced Parkinsonism and the fact that you have developed some sort of tremors in your arm so it not safe to be continued.
Although one of the most effective anti emetics, the use of Ondansetron could result in constipation which may aggravate your symptoms of IBS.
In view of the above, I would suggest you to take either Mosapride or Tegaserod which are found to be effective antiemetic drugs with minimal side effects.
Another option may be Selective serotonin re-uptake inhibitors (SSRIs) which are shown to significantly accelerate intestinal transit and might be useful in your case.
Hope I could answer your query.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you for your answer doctor although I dont think we have either of those medications here in the United Kingdom. Out of the anti-emetics that I have mentioned above - which one do you think I should try long term as I have those at home ready to take? Also, if I continue with the Ondansetron could you please recommend a gentle laxative that will not cause vomiting or nausea or any harsh side effects? I have tried Lactulose but that gives me cramps and bad wind/bloating. I have tried Movicol but that makes me feel even more sick. Thank you
Brief Answer:
Ondansetron may be tried as a long term anti emetic
Detailed Answer:
Hi.
Thanks for your compliment and the follow up query.
Bulk forming laxatives are effective for the symptomatic relief of constipation.
Psyllium (Ispaghula husk) or Metamucil are found to be effective in the treatment of constipation suffering from IBS.
However, usually a dietary modification can help many people with IBS manage constipation. Dietary fiber reduces constipation by softening the stool, making it easier to pass.So,
1. Include high-fiber foods into your diet.
2. Avoid coffee, carbonated drinks, and alcohol. They can slow the passage of stool. So can refined foods such as chips, cookies, and white rice.
3. Do regular exercise
4. Take plenty of oral fluids
Hope I could answer your query.
Wishing you best of your health.
Ondansetron may be tried as a long term anti emetic
Detailed Answer:
Hi.
Thanks for your compliment and the follow up query.
Bulk forming laxatives are effective for the symptomatic relief of constipation.
Psyllium (Ispaghula husk) or Metamucil are found to be effective in the treatment of constipation suffering from IBS.
However, usually a dietary modification can help many people with IBS manage constipation. Dietary fiber reduces constipation by softening the stool, making it easier to pass.So,
1. Include high-fiber foods into your diet.
2. Avoid coffee, carbonated drinks, and alcohol. They can slow the passage of stool. So can refined foods such as chips, cookies, and white rice.
3. Do regular exercise
4. Take plenty of oral fluids
Hope I could answer your query.
Wishing you best of your health.
Above answer was peer-reviewed by :
Dr. Sonia Raina
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