Cimazine

Quick links to important sections

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cimazine

Property Description
Active ingredient Chlorpromazine (often as the hydrochloride salt)
Form Tablet, liquid oral solution, or injectable solution
Pharmacological class First-generation antipsychotic (Neuroleptic)
Common purpose Stabilizing severe disturbances in thought and mood
Origin Synthetic, derived from phenothiazine

Core Identity and Classification

Cimazine is the trade name for a medicine containing the active substance Chlorpromazine, which is the prototypical first-generation antipsychotic agent, often referred to as a neuroleptic. This medicine is a synthetic compound belonging chemically to the phenothiazine derivative group. Chlorpromazine is recognized as one of the most versatile psychoactive agents and is widely classified as an essential medicine. This recognition underscores the critical role this medicine plays in healthcare systems, particularly as it is clinically recognized for its ability to manage acute psychotic states.


Composition and Available Forms

The preparation is a single-ingredient product featuring Chlorpromazine, typically formulated as the hydrochloride salt, which confirms that its core action is attributed to this one active compound. To accommodate varying clinical needs, Cimazine is manufactured in several dosage forms, including the standard oral tablet, the liquid oral solution, and the sterile injectable solution. This variety ensures the drug can be administered either for routine management via the oral route or for rapid intervention through the parenteral (intramuscular or intravenous) route.

What side effects are possible with Cimazine?

Possible side effects and safety information

Cimazine (Chlorpromazine) has an officially documented safety profile characterized by effects across several organ systems, with adverse reactions formally categorized by frequency in regulatory documents.

Frequency-Classified Adverse Reactions

Adverse effects are documented using standard frequency bands:

  • Very Common (affecting 1 in 10 or more people): Includes sedation, drowsiness, dry mouth, constipation, blurred vision, and orthostatic hypotension (dizziness upon standing).
  • Common (affecting up to 1 in 10 people): Includes weight gain, photosensitivity (increased sun sensitivity), and extrapyramidal symptoms (e.g., Akathisia, Parkinsonism).
  • Rare (affecting up to 1 in 1,000 people): Includes Neuroleptic Malignant Syndrome (NMS), agranulocytosis (severe reduction in white blood cells), jaundice, and Tardive Dyskinesia.

Serious Safety Considerations

Regulatory information specifies risks of rare but serious systemic reactions. Neuroleptic Malignant Syndrome (NMS) is documented as a potentially fatal adverse reaction. Other serious effects include agranulocytosis, which requires blood count monitoring, and Tardive Dyskinesia (TD), a movement disorder often associated with long-term exposure. The label also notes the potential for QT interval prolongation and severe cardiac arrhythmias.


Population- and Exposure-Related Safety

Safety statements include specific warnings for defined groups. Antipsychotic drugs are associated with an increased risk of death in older adults with dementia-related psychosis. Sedation is typically most pronounced early in treatment, while TD is generally associated with long-term exposure. The medicine is contraindicated in conditions such as comatose states or severe bone marrow depression.

Overdose and Emergency Response

Overdose and when to seek help

This section describes the officially documented manifestations and required emergency actions for an overdose of Cimazine (Chlorpromazine), based strictly on regulatory prescribing information.


Documented Overdose Manifestations

Overdose primarily affects the central nervous system (CNS) and cardiovascular system. CNS effects may include drowsiness, confusion, agitation, seizures, and progression to coma. Documented cardiovascular signs include severe hypotension (very low blood pressure), tachycardia, and QT interval prolongation, which creates a risk for life-threatening arrhythmias and sudden cardiac death. Other severe outcomes include respiratory depression and the potential for Neuroleptic Malignant Syndrome (NMS).


Required Emergency Actions

Seek immediate medical attention for any suspected overdose. Regulatory guidance mandates that emergency services be contacted immediately if an individual exhibits severe toxicity, such as having a seizure, difficulty breathing, or being unresponsive. Treatment is exclusively symptomatic and supportive, as no specific antidote is available for Chlorpromazine. Management involves rigorous supportive care, including continuous cardiac monitoring (ECGs) and measures such as activated charcoal or gastric lavage in early presentation to manage systemic instability.

Therapeutic Uses of Cimazine

What Cimazine Treats: Main Uses and Benefits

Cimazine is considered relevant for easing symptoms related to severe psychiatric and behavioral disturbances. It is commonly used for conditions including schizophrenia, the manic phase of bipolar illness, and acute agitation. It is considered relevant within therapeutic areas involving heightened responses, which supports the patient during difficult episodes by easing distress.


The medication is applied across domains where additional symptomatic support is needed, primarily addressing symptom clusters that may become intense or disruptive, such as delusions, hallucinations, and combative behavior. It is commonly used when short-term symptomatic assistance is needed, supporting patients during difficult episodes by easing distress.

“Supports the patient during difficult episodes by easing distress and assists with maintaining functional stability.”

Quick Fact: Supports management of Intractable Hiccups

Beyond its psychiatric role, Cimazine is applied in scenarios where additional management of discomfort is required, helping with severe, prolonged episodes of nausea and vomiting (emesis) and treating persistent, unremitting hiccups (singultus) that create noticeable physiological strain. This specialized use supports general well-being during symptomatic phases by contributing to easing the overall symptom load.

Regulatory References

  1. DailyMed FDA Prescribing Information

Eligibility and Restrictions for Use

Absolute Contraindications

Cimazine is contraindicated and must not be used by patients who have a known hypersensitivity to phenothiazines or any component of the medicine. It is also prohibited for individuals in comatose states, experiencing severe Central Nervous System (CNS) depression, or having active bone marrow depression or other blood dyscrasias. Furthermore, the medicine is not approved for treating elderly patients with dementia-related psychosis due to documented increased risk of death.


Conditional Use and Special Populations

Use is generally not recommended for children under one year of age, and for pediatric patients, use must be avoided if signs suggestive of Reye’s syndrome are present. Patients with a history of epilepsy or seizures should use Cimazine with caution, as the drug may lower the seizure threshold. Those with severe hepatic (liver) or renal (kidney) impairment require close monitoring due to the risk of drug accumulation.


Pregnancy and Lactation

Cimazine is generally not recommended during pregnancy unless the benefit clearly outweighs potential risk. Neonates exposed during the third trimester are an at-risk population for extrapyramidal and withdrawal symptoms post-delivery. Use is also not recommended for women who are breastfeeding.

What should I know about interactions with other medicines?

Cimazine, an antipsychotic medication, is primarily metabolized by the cytochrome P450 (CYP450) liver enzyme system, particularly the CYP2D6 and CYP1A2 isoenzymes. Therefore, co-administration with other substances that inhibit or induce these enzymes can significantly alter Cimazine's concentration in the bloodstream, leading to either increased side effects or reduced efficacy.

Clinically significant interactions include:

  • Central Nervous System (CNS) Depressants: Combining Cimazine with drugs such as opioids, benzodiazepines (e.g., diazepam, alprazolam), barbiturates, or alcohol can intensify CNS depression, potentially causing severe drowsiness, sedation, respiratory depression, and even coma. Use of these combinations should be carefully monitored.
  • Drugs Affecting QT Interval: Cimazine can prolong the QT interval on an electrocardiogram. Co-administration with other medicines that also carry this risk (e.g., certain antiarrhythmics, antifungals, or other antipsychotics) may increase the danger of serious heart rhythm abnormalities.
  • CYP450 Inhibitors: Potent inhibitors of CYP2D6 (e.g., fluoxetine, paroxetine) or CYP1A2 (e.g., cimetidine, fluvoxamine) may increase Cimazine plasma levels, necessitating a dose reduction to avoid toxicity. Conversely, strong enzyme inducers (e.g., carbamazepine, rifampicin) may decrease Cimazine levels, leading to loss of therapeutic effect.
Product Interaction Effect Clinical Significance
Alcohol Increased CNS depression, sedation Major
Grapefruit Juice Potential increase in Cimazine concentration (CYP3A4 inhibition) Moderate
Tobacco Smoking Decreased Cimazine concentration (CYP1A2 induction) Moderate

Patients should inform their healthcare provider of all prescription drugs, over-the-counter medicines, herbal supplements, and dietary products currently being taken.

Mechanism of Action

Central Dopamine Receptor Blockade

Chlorpromazine primarily acts by blocking the Dopamine D2 receptors in specific brain pathways, notably the mesolimbic system. This antagonism reduces the ability of dopamine to bind and activate these receptors, leading to a reduction of excessive dopaminergic signaling that influences central nerve activity.


Modulation of Arousal and Emetic Centers

The drug engages other targets, including the Histamine H1 receptor and the Muscarinic acetylcholine receptor ( M1), which are integral to the Reticular Activating System (RAS). The resulting H1 antagonism produces significant CNS depression by decreasing the activity of arousal centers, while D2 blockade in the Chemoreceptor Trigger Zone (CTZ) modulates the activity of the emetic center.


Influence on Peripheral Autonomic Signaling

Chlorpromazine further affects the body by blocking Alpha1-adrenergic receptors (alpha1) found on the smooth muscle of peripheral blood vessels. This blockade prevents the signals that cause vasoconstriction, thereby contributing to a reduction in systemic vascular resistance and altering vascular tone.

Dosage and Administration Information

How to Use Cimazine

Cimazine, which contains chlorpromazine, is administered using specific protocols to ensure proper dosing and consistent application. The approved routes of administration include oral (tablets and solutions), intramuscular (IM) injection, and intravenous (IV) infusion, with the choice depending on the acuity of the patient's condition.


Dosing and Administration Cadence

Treatment is initiated using a low starting dose and requires gradual titration (slow increase) until the appropriate maintenance dose is established. For psychiatric disorders, the initial adult oral dose often starts between 10 mg and 25 mg three times daily, with maintenance doses typically ranging from 75 mg to 300 mg daily in divided doses.

Usage Context Standard Adult Dose Regimen
Routine Oral Maintenance 75 mg to 300 mg daily, in divided doses
Acute IM Injection 25 mg initially, repeatable in 1–4 hours
Intractable Hiccups 25 mg to 50 mg three or four times daily

Procedural Requirements

For parenteral administration (IM or IV), the patient is instructed to remain recumbent (lying down) during and for at least 30 minutes following the injection. IV formulations require dilution prior to slow infusion. In terms of patient-specific adjustments, older or debilitated adults and pediatric patients must begin treatment with one-third to one-half the usual adult starting dose, accompanied by a slower titration schedule. Additionally, oral tablets must not be crushed, and the oral solution should not be consumed simultaneously with antacids, tea, or coffee.

Recent Clinical Evidence

Cimazine (Chlorpromazine) has been extensively studied in research exploring its effect on symptoms related to schizophrenia and acute psychotic episodes. The primary evidence base consists of short-term Randomized Controlled Trials (RCTs) and Meta-analyses that measured changes in overall symptom severity in adult populations compared against placebo or other compounds. Studies reported findings that describe patterns observed in these short-term measurements, which contributes to the broader evidence landscape for conditions characterized by fluctuating symptoms.

However, many foundational trials are older, and modern scientific reviews often cite a low level of confidence in the evidence quality due to methodological limitations in these studies. For non-psychiatric uses, such as managing severe, persistent hiccups (singultus) and episodes of nausea and vomiting (emesis), the evidence is largely composed of Case Reports and Case Series. This data show patterns related to the cessation or reduction of symptoms in documented cases, but comparative evidence is lacking against modern, targeted treatments, and sample sizes were modest.

Long-term studies explored the extended-duration patterns of the medicine's use. A key point of uncertainty is that long-term effects are not fully established with the same certainty as short-term changes, and comprehensive data for outcomes beyond a few years remain insufficient. Research was evaluated in various patient groups, but data for certain groups remain insufficient, and comparative evidence is lacking against the full range of modern compounds available today.

Key Studies & References

  1. CHLORPROMAZINE HYDROCHLORIDE Tablets, USP - FDA DailyMed Label
  2. WHO Model List of Essential Medicines (EML) - Chlorpromazine for psychotic disorders

Frequently Asked Questions (FAQ)

Common questions about Cimazine (FAQ)


Q: How quickly should I expect Cimazine to start working?

Regulatory data on pharmacokinetics indicates that measurable levels of the drug are typically reached within 30 to 60 minutes after oral administration, with peak concentrations often observed within two to four hours. These figures describe the drug's presence in the bloodstream, not necessarily the onset of the desired clinical effect.


Q: What happens if I stop taking Cimazine suddenly?

Official regulatory information cautions against suddenly stopping this medicine, as doing so may result in withdrawal symptoms. It is important that any decision to stop treatment be discussed with a healthcare provider, who can establish a safe tapering schedule.


Q: Is it true that Cimazine is used for multiple different conditions?

Official documents confirm that the medicine is approved for treating a variety of conditions. These include certain psychotic disorders, as well as specific non-psychiatric uses such as managing intractable hiccups and controlling severe nausea and vomiting.


Q: Is Cimazine a type of antibiotic, anti-inflammatory, or something else?

According to major health organizations and regulatory documents, the active ingredient, Chlorpromazine, is formally classified as a first-generation antipsychotic agent. These medicines are sometimes referred to as neuroleptics.


Q: Is it necessary to avoid alcohol completely while using Cimazine?

Official warnings advise that the use of alcohol with this medicine should be avoided. Combining them may increase sedative effects and carries a risk of contributing to hypotension (low blood pressure).


Q: How long does Cimazine stay in your system after stopping it?

Clinical pharmacology data shows that the active drug has a half-life ranging between 23 and 37 hours. Based on this rate, full clearance from the body can take several days, though individual metabolism can vary.


Q: Can Cimazine affect my sleep or cause insomnia?

Official regulatory documents list both types of sleep-related effects. While drowsiness and sedation are very common, trouble sleeping or insomnia is also reported as a potential adverse effect.


Q: Is Cimazine safe for older adults to use?

Official warnings note that this medicine is not indicated for use in elderly patients with dementia-related psychosis. This is due to a documented increased risk of death associated with antipsychotic drugs in this specific population.


Q: Is Cimazine a controlled substance?

The active ingredient Chlorpromazine is not classified as a controlled substance. Based on the legal framework, it is not listed under the schedules regulated by the US Drug Enforcement Administration (DEA).


Q: Does Cimazine affect blood pressure?

Regulatory documentation reports that the medicine can cause a temporary lowering of blood pressure, known as hypotension. This effect may be associated with symptoms like dizziness or fainting, particularly when changing position (orthostatic hypotension).


Q: Can I drive or operate machinery while using Cimazine?

Regulatory warnings state that this medicine may impair mental or physical abilities, especially when therapy is initiated. Due to the potential for impairment, activities requiring complete mental or physical alertness, such as operating hazardous machinery or driving, are often cautioned against.


Q: Is there a generic version of Cimazine available?

Yes, the patent for the active ingredient has expired. Generic formulations of chlorpromazine are widely available and are considered clinically equivalent to the brand name product.


Q: Does Cimazine need to be kept refrigerated?

No, official storage instructions advise keeping the medicine at a controlled room temperature, typically between 20 C and 25 C. The medicine is generally required to be protected from light and should not be frozen.


Q: Can Cimazine affect fertility or cause reproductive issues?

As with other similar medicines, this drug can raise levels of the hormone prolactin. In women, this increase in prolactin may be associated with changes in the menstrual cycle, which is considered a potentially reversible cause of infertility.


Q: Do I need to get blood tests while taking Cimazine?

Due to the rare risk of a severe reduction in white blood cells (agranulocytosis), monitoring of blood counts may be established by the prescribing healthcare provider. This monitoring is typically done based on individual risk factors and regulatory guidance.


Q: Can people with heart conditions use Cimazine?

Official documentation notes that caution is recommended when the drug is administered to persons with severe cardiovascular disease. This is due to the potential for effects on the heart's electrical conduction and the risk of hypotension.


Q: Why are there different strengths of Cimazine available?

Different strengths are manufactured to support the official requirement for proper dosing. Treatment is often initiated at a low starting dose, followed by a gradual increase, or titration, to establish a stable maintenance dose.


Q: Does Cimazine cause any skin reactions or rashes?

Official records confirm potential skin reactions. In addition to increased sensitivity to the sun (photosensitivity), general skin reactions, rash, and contact skin sensitization are also listed as possible adverse effects.


Q: Is Cimazine a prescription-only medicine?

Yes, this medicine is classified as a prescription-only drug. It requires a valid prescription from a licensed healthcare provider for its dispensing and use.


Q: How does the FDA classify the safety of Cimazine?

The FDA has phased out the old letter-based system for classifying drug safety during pregnancy. However, other global regulatory bodies, such as the Australian TGA, classify the medicine as Pregnancy Category C.


Q: Can I take Cimazine with my allergy medicine?

Official documents caution that combining this medicine with common allergy medicines (antihistamines) may increase anticholinergic side effects. These include increased drowsiness, blurred vision, dry mouth, and possible difficulty with urination.


Q: Do studies support the long-term use of Cimazine?

Official warnings note that the risk of developing long-term movement disorders, such as Tardive Dyskinesia (TD), is understood to increase with the duration of treatment. This risk profile is considered when determining the overall course of therapy.


Q: Are there any specific foods that interact with Cimazine?

Yes, official regulatory guidance advises that the liquid oral concentrate form of the medicine should not be mixed with nutritional supplements or tube feedings. This is because mixing the medicine with these products may reduce its absorption and effectiveness.


Q: Can Cimazine be taken by people with kidney issues?

For patients with renal (kidney) impairment, close monitoring is generally recommended. Regulatory guidance suggests caution, as there is a potential for the medicine to accumulate in the body when kidney function is reduced.


Q: Is Cimazine safe to take if I have liver problems?

For patients with hepatic (liver) impairment, close monitoring is generally recommended when using this medicine. This is due to the potential for drug accumulation and the risk of liver injury.


Q: Is Cimazine linked to any long-term health risks?

Official safety documentation confirms potential long-term risks. Aside from the movement disorder Tardive Dyskinesia, official documents also describe the potential for the development of deposits in the cornea or lens of the eye with extended use.


Q: Do I need to take Cimazine with food?

Official information provides specific instructions regarding the liquid oral solution (such as not mixing it with coffee, tea, or antacids). However, regulatory information does not contain an explicit instruction stating that the tablets must be taken with food.


Q: Why do some patient information leaflets list so many possible side effects for Cimazine?

Official documents explain that the active ingredient works by blocking several different types of chemical receptors in the brain and body. This broad activity across different systems is understood to contribute to the extensive list of documented possible side effects.


Q: Is Cimazine considered a long-term maintenance medicine?

Yes, the official dosing guidelines for psychiatric disorders include a 'maintenance dose' regimen. This indicates that the medicine is used in long-term management following a successful initial stabilization phase.


Q: Has Cimazine been extensively studied in younger populations?

Regulatory dosage information exists for children 6 months of age and older. However, official documents state that safety and efficacy have not been established for children younger than 6 months of age.

How should Cimazine be stored and disposed of?

How to Store and Dispose of Cimazine? (Chlorpromazine)

Cimazine (Chlorpromazine) requires specific conditions to maintain its stability, as mandated by regulatory authorities.

Storage Scope Official Regulatory Requirements
Temperature Store at Controlled Room Temperature (20 C to 25 C), with permissible brief excursions up to 30 C.
Protection The product must be protected from light; liquid forms, such as the oral concentrate, should be dispensed in amber glass bottles.
Freezing/Container Do not freeze liquid formulations. Keep all forms in the original container or light-resistant packaging and tightly closed.
Child Safety The medicine must be kept out of the sight and reach of children and stored securely, often specified as locked up.
Disposal Dispose of unused or expired product in accordance with local regulations. Avoid discharge into drains or wastewater; special waste collection points are often required for proper handling.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Cimazine found in:

A-Z Index: