Does Medicare Cover Compazine?

Nausea and vomiting are uncomfortable gastrointestinal symptoms that occur for many reasons, with the most common cause being viral gastroenteritis, sometimes referred to as stomach flu.

In some cases, medications, surgical procedures and chronic conditions may lead to extended, severe bouts of nausea and vomiting, and individuals are sometimes prescribed prochlorperazine, an anti-nausea medication often sold under the brand names Compazine and Compro.

In addition to treating severe nausea, prochlorperazine is sometimes prescribed as an anti-psychotic medicine to individuals with schizophrenia and other psychological conditions. 

Does Medicare Cover Compazine?

Medicare does not cover Compazine, as the brand name has been discontinued in the United States, but certain Medicare Advantage and Medicare Part D plans may cover 100% of generic prochlorperazine costs. Specific plan details and coverage options can vary based on a recipient's geographical location and whether they're in the Medicare deductible stage or Medicare copay stage.

During the deductible stage, Medicare beneficiaries are generally required to pay 100% of their prescription costs out of pocket. After a recipient meets the Medicare deductible, they either pay a copayment or a coinsurance percentage for all covered medications. 

The full cost for generic prochlorperazine is approximately $23 to $36 per prescription. During the copayment or coinsurance stage, Medicare recipients should expect to pay approximately $0 to $1 per prescription. As of 2024, Medicare drug plan deductibles cap off at $545.

How Does Prochlorperazine Treat Nausea and Vomiting?

Prochlorperazine helps prevent and treat nausea and vomiting by targeting the dopamine receptors in the brain that trigger the feeling of nausea, which leads to the action of vomiting. Prochlorperazine is referred to as a dopamine receptor antagonist medication, as it creates a block between dopamine and dopamine receptors to prevent nausea and halt the body's vomiting reflex. 

How Does Prochlorperazine Treat Psychological Conditions?

Similar to how it treats nausea and vomiting, Prochlorperazine blocks hyperactive dopamine receptors in the brain. In individuals with schizophrenia and other psychological conditions, medications that specifically target dopamine receptors have been shown to help reduce psychotic symptoms. Prochlorperazine also has sedative properties that may help promote calmness in individuals with non-psychotic anxiety.

Does Prochlorperazine Cause Serious Side Effects?

Prochlorperazine can cause a wide range of side effects, many of which are severe. Common side effects include dry mouth, headaches, drowsiness and a stuffy nose. These side effects are considered normal and generally resolve on their own.

Severe side effects of prochlorperazine include uncontrollable face or tongue movements, high temperature and muscle shaking and stiffness. Prochlorperazine can also cause yellowing of the eyes, which may indicate liver function problems. These side effects are considered severe and require immediate medical attention.