Levomepromazine

(R) - [3 - (2- Methoxyphenothiazin -10 -yl) - 2-methylpropyl ]-N, N -dimethylamine

• 60-99-1
• 1236-99-3 ( levomepromazine hydrochloride)

N05AA02

Antipsychotic phenothiazines

9.19

Practically insoluble in water (20 mg · l-1 at 25 ° C)

1100 mg · kg -1 ( LD50, rat, oral)

Template: Infobox chemical / molecular formula search available

Levomepromazine is a drug from the group of phenothiazines, which is used in psychiatry. It is a potent low (weak ) antipsychotic, which serves more than sleeping and Sedationsmittel.

Action profile

As low potent neuroleptic stands at levomepromazine the sedative component in the foreground of the action spectrum; the antipsychotic properties are rather low. Below is levomepromazine et al is administered in psychomotor agitation, which is why it often, popularly speaking, in the form of " calming splash ".

Indications

Levomepromazine is approved for use in arousal states that occur in the context of psychotic disorders or mania.

As a special feature among the phenothiazines is still next to the indication for the combination therapy of severe or chronic pain.

Dosage forms, dosage

Levomepromazine is present in commercial preparations in the form of tablets and drops / oral solution and as a solution for injection.

The average daily dose is 30-75 mg (stationary maximum of 300 mg per day). The daily dose is intended to be divided into several doses, in which a half or a greater part is to be administered in the evening.

Side effects

• Very common: especially at the beginning of treatment, at high doses or parenteral administration may lead to increased fatigue, vegetative disorders with marked orthostatic dysregulation ( reaction with position changes ), low blood pressure, tachycardia ( persistently rapid pulse ) and ECG changes.

• Common: ( to remain urge to move, inability to sit ) extrapyramidal side effects such as Frühdyskinesien ( tongue - pharyngeal spasm, torticollis, jaw muscle spasms, look cramps, stiffening of the back muscles ), Parkinson's disease ( hypomimia, tremor, rigidity, akinesia, drooling ), akathisia. In these cases a reduction of the dose and co-medication is to come with an anti- Parkinson drug such as biperiden into consideration. Autonomic side effects such as difficulty focusing, dry mouth, feeling of nasal congestion, increased intraocular pressure, constipation and voiding dysfunction often occur as nausea, vomiting, diarrhea and loss of appetite.

• Uncommon: allergic reactions, allergic skin reactions and photosensitivity, also pigment deposits in the cornea and lens, severe liver dysfunction, outflow disorders of bile, jaundice (jaundice), restlessness, agitation, dizziness, depressed mood, lethargy, dizziness, exacerbation of psychotic symptoms, rare characters of excitement and confusion - especially under combination with anticholinergic - active drugs - and cerebral seizures and dysregulation of body temperature.

Chemistry

The synthesis of levomepromazine described in the literature. Levomepromazine is exclusively used medicinally in the enantiomerically pure ( R)-form.

Trade names

Levium (D), Neurocil (D), Nozinan (A, CH ), various generics (D)