Stemetil
⚡ Quick Answer — What is Stemetil?
Stemetil is prochlorperazine maleate 5 mg — a phenothiazine first-generation antipsychotic widely used at low doses for severe nausea and vomiting, vertigo, Meniere’s disease, and the labyrinthine vertigo of inner-ear dysfunction. It blocks central D2 dopamine receptors in the chemoreceptor trigger zone (antiemetic) and in the labyrinth (anti-vertigo), and to a lesser extent histamine H1 and muscarinic receptors. Standard dose: 5–10 mg three times daily orally for nausea or vertigo, max 30 mg/day; bipolar/schizophrenia at higher doses is rarely used today given atypical antipsychotic alternatives. WHO-GMP certified manufacturer.
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Why order from MedsBase
Our generic medications are sourced from WHO-GMP certified manufacturers and shipped worldwide in discreet, plain packaging — no medication name on the parcel exterior. Card payments are routed through a regulated processor (statement descriptors include a regulated card-payment processor — never “MedsBase” or any medication name). Crypto and SEPA bank transfer are also accepted. Every order is backed by our Reshipment Assurance Policy.
Why order from MedsBase
Stemetil is supplied from a WHO-GMP certified manufacturer. Every order ships discreetly worldwide and is covered by our Reshipment Assurance Policy — if it does not arrive within 20 business days, we reship at no cost. Stemetil is a long-established antiemetic and vestibular suppressant used worldwide for severe nausea, vertigo, and Meniere's symptom flares.
Mechanism
Prochlorperazine antagonises central D2 dopamine receptors. In the chemoreceptor trigger zone this produces a strong antiemetic effect (more potent than metoclopramide for severe vomiting). In the inner ear and brainstem vestibular nuclei it suppresses vertigo. H1 antagonism explains the sedation; muscarinic antagonism explains dry mouth. At higher doses it has the typical FGA pharmacology (positive-symptom psychosis suppression).
Indications
- Severe nausea and vomiting (chemo, post-op, migraine, gastroenteritis)
- Vertigo (vestibular neuronitis, BPPV with severe symptoms, Meniere's flare)
- Meniere’s disease symptom relief (combined with diuretic / dietary salt restriction)
- Labyrinthitis
- Schizophrenia (rarely — superseded by atypicals)
Dose
Adults: 5–10 mg three times daily orally for nausea/vertigo. Acute migraine-associated nausea: 5–10 mg single dose. Meniere’s: 5 mg three times daily, titrate to symptom control (max 30 mg/day). Children: avoid < 10 kg. Hepatic impairment: reduce dose. Elderly: start at half-dose — very high EPS risk.
Side effects
- Common: drowsiness, dry mouth, constipation, blurred vision, postural hypotension
- Extrapyramidal: acute dystonia (oculogyric crisis, torticollis), akathisia, parkinsonism, tardive dyskinesia
- Hyperprolactinaemia: galactorrhoea, menstrual changes
- QT prolongation, torsades de pointes (rare)
- Photosensitivity skin rash, cholestatic jaundice (idiosyncratic)
- Neuroleptic malignant syndrome (rare, life-threatening)
Drug interactions
- Other dopamine antagonists (metoclopramide, haloperidol, atypicals): additive EPS — avoid stacking.
- QT-prolonging drugs (azithromycin, fluoroquinolones, ondansetron, citalopram, methadone): avoid combination.
- CNS depressants (alcohol, opioids, benzodiazepines): additive sedation, hypotension.
- Levodopa, dopamine agonists: each blocks the other's effect — avoid in Parkinson’s.
- Anticholinergics: additive dry mouth, urinary retention, constipation.
Frequently Asked Questions
What is Stemetil mainly used for?
Severe nausea, vomiting, and vertigo. It is more potent than metoclopramide for severe vomiting and is the standard for vestibular vertigo flares.
How quickly will it work?
Antiemetic effect within 30–60 minutes orally. The IM and rectal routes (5 mg or 25 mg suppositories) act within 30 minutes when the patient cannot keep tablets down.
Is it safe to drive on this?
Drowsiness is common. Do not drive until you know how it affects you. The first 1–2 weeks are usually most sedating.
Can I take it with my migraine medication?
Yes — prochlorperazine is often combined with triptans and analgesics during a migraine attack to control nausea. Avoid with QT-prolonging triptan combinations and tell the prescriber.
Is it the same as metoclopramide?
Both are D2 antagonists. Prochlorperazine is more potent for severe vomiting and is preferred for vertigo. Metoclopramide is more prokinetic. Both share extrapyramidal side-effect risk.
Why am I getting muscle spasms?
Acute dystonia is a recognised early side effect — uncontrolled muscle pulling in the neck, jaw, eyes, or trunk. Stop the drug and seek medical help. Treated with IV anticholinergic (procyclidine).
Can I take it long-term for Meniere’s?
Short-to-medium courses for symptom flares are typical. Long-term use (months) raises tardive dyskinesia risk — specialist ENT/neurology supervision recommended.
Is it safe in pregnancy?
Category C. Sometimes used for severe hyperemesis gravidarum when first-line fails. Discuss with obstetric prescriber.
Storage
Below 25°C, away from light. Keep out of reach of children.
What if I miss a dose?
Take it as soon as you remember. If close to the next dose, skip it. Do not double up.
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