Classification: phenothiazine; neuroleptic
  • antipsychotic
  • anxiolytic
  • sedative and analgesic properties
  • Bolus: 
    • 5-25 mg IV direct
  • Infusion: 
    • 2-8 mg/hr, titrated to patient response
    • A provider order is required for each infusion rate change (nurses are not approved to titrate to effect). Rate change recommendations are by 1-2 mg/hr every 2-4 hours to as required). 

IV Infusion: 
50 mg/50 ml dextrose 5% or sodium chloride 0.9% for syringe pump infusion or 100mg/100ml dextrose 5% or sodium chloride 0.9%

Adverse Effects:
  • anticholinergic effects:
    • urinary retention
    • tachycardia
  • orthostatic hypotension
  • drowsiness
  • agranulocytosis (rare)
  • cholestatic jaundice
  • malignant neuroleptic syndrome
  • altered thermic response (poikilithermic effect) thus may not be able to adapt to temperature changes
  • in patients with glaucoma, due to anticholingergic effects
  • in epileptic patients due to possible reduction of seizure threshold
Drug Interactions:
  • methotrimprazine + epinephrine = diminished effect of epinephrine on blood pressure
  • methotrimprazine + CNS depressants = increased CNS depressant effects
Monitoring Therapy:
  • continuous heart rate and rhythm
  • QT interval
  • blood pressure
  • mental status, delirum screen
  • urine output
  • muscle rigidity, fever, altered metal state
  • bilirubin
  • appropriate response to ambient temperature, temperature
  • CBC
  • level of sedation
Adult Critical Care Protocol:
  • May be administed IV direct or by IV infusion by a nurse in Adult Critical Care
  • Continuous infusions must be administered by infusion device with pump library enabled.
Last Update: April 28, 2006

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: September 20, 2018, Updated June 6, 2019