Concise Prescribing Info
Lised in Dosage.
Dosage/Direction for Use
Adult: PO Schizophrenia As maleate: 25-50/day in 3 divided doses, w/ higher dose at night. Non-ambulant: 100-200 mg/day. Max: 1g/day. Adjunct in severe terminal pain; Nausea and vomiting As maleate: 12.5-50 mg 4-8 hrly. Sedation 10-25 mg at bedtime. IV/IM Adjunct in severe terminal pain; Nausea and vomiting As HCl: 12.5-25 mg 6-8 hrly. Severe agitation: Up to 50 mg IM Acute pain As HCl: 75-100 mg in 3-4 deep inj. Post-op pain As HCl: 10-25 mg 8 hrly, 2.5-7.5 mg 4-6 hrly if residual effect of anesth present. Premed in surgical procedures As HCl: 10-25 mg 8 hrly . Final pre-op dose: 25-50 mg approx 1 hr before surgery.
Comatose state, severe CNS depression, phaeochromocytoma, blood dyscrasia.
Special Precautions
Reduced GI motility, urinary retention, prostatic hyperplasia, xerostomia or visual problems, narrow-angle glaucoma, myasthenia gravis. Cardiac conduction abnormalities. Patients at risk of hypotension or CV or cerebrovascular disease. Bone marrow suppression. Severe renal, cardiac or hepatic disease. Respiratory disease. Predisposition to seizures. May affect driving, especially at start of treatment. Elderly, children. Pregnancy and lactation.
Adverse Reactions
Hypotension, orthostatic hypotension, tachycardia, QT prolongation; photosensitivity, rash; gynaecomastia, wt gain, irregular menstruation, changes in libido; extrapyramidal effects, dizziness, seizure, headache, drowsiness, neuroleptic malignant syndrome, interference with temperature regulation; constipation, nausea, vomiting, ileus; urinary retention, ejaculatory disorders, incontinence, polyuria, priapism; blood dyscrasias; jaundice, hepatotoxicity.
Potentially Fatal: Arrhythmias. Severe orthostatic hypotension.
Drug Interactions
Increased risk of extrapyramidal effects with metoclopramide, acetylcholinesterase inhibitors. Additive hypotensive effects with antihypertensive agents, trazodone. Additive sedative effects with CNS depressants. May alter levels/effects of CYP2D6 substrates and prodrug substrates. Reduced pressor effects of epinephrine. Reduced effects of bromocriptine, guanethidine, guanadrel, levodopa. Increased neurotoxicity with lithium (rare). Reduced serum levels with phenytoin or increased phenytoin toxicity. Increased serum concentrations with propranolol, sulfadoxine-pyrimethamine. Increased serum levels of valproic acid. Reduced absorption with aluminium salts. Reduced effects of amphetamines or increased risk of psychotic symptoms. Reduced effects and excessive anticholinergic effects with benztropine, trihexyphenidyl, biperiden, TCAs, antihistamines, disopyramide.
ATC Classification
N05AA02 - levomepromazine ; Belongs to the class of phenothiazine antipsychotics with aliphatic side-chain.
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