title: Chlorpromazine bioavailability from a topical gel formulation in volunteers.
abstract: BACKGROUND
  Symptom management medications are often compounded into topical gel formulations providing an alternative route of administration for hospice and palliative care patients. Though commonly used, transdermal absorption and bioavailability studies of these gel products are lacking. Chlorpromazine was studied because it is FDA approved for treatment of nausea and vomiting and is used off-label for treatment of agitation and delirium.
  
  
  OBJECTIVE
  The objective of this study is to determine the transdermal absorption of chlorpromazine PLO gel in healthy adults.
  
  
  METHODS
  Twenty-five milligrams of chlorpromazine in PLO gel was applied to 10 subjects' wrists and 100 mg was applied to 1 subject's wrist. Blood draws were completed preapplication and 1, 2, and 4 hours postapplication. This single-center unblinded study recruited healthy adults between 18 and 70 years of age. Participants were not pregnant, did not have an allergy to any component of the study medication, and were not taking a phenothiazine medication.
  
  
  RESULTS
  Chlorpromazine was undetected in any of the 11 subjects' blood samples.
  
  
  CONCLUSIONS
  There is an assumption of equivalent medication absorption in healthy patients and palliative care or hospice patients.
  
  
  CONCLUSIONS
  Rapid relief of symptoms at end of life is essential. Chlorpromazine in PLO gel may not be an effective treatment option since blood levels were undetectable at 1, 2, and 4 hours after topical application.
authors.affiliation: HospiScript Services a Catamaran Company, Dublin, Ohio, USA. asuchecki@hospiscript.com
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Weiland
authors.affiliation: HospiScript Services a Catamaran Company, Dublin, Ohio, USA.
authors.forename: Bridget McCrate
authors.initials: BM
authors.lastname: Protus
authors.affiliation: HospiScript Services a Catamaran Company, Dublin, Ohio, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Kimbrel
authors.affiliation: HospiScript Services a Catamaran Company, Dublin, Ohio, USA.
authors.forename: Phyllis A
authors.initials: PA
authors.lastname: Grauer
authors.affiliation: The Ohio State University, Columbus, Ohio, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hirsh
mesh_terms: D000328:Adult; D001682:Biological Availability; D002626:Chemistry, Pharmaceutical; D002746:Chlorpromazine / Q000493:pharmacokinetics*; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D012869:Skin Absorption
chemical_list: D005782:Gels; D002746:Chlorpromazine