Levomepromazin

When ATH:
N05AA02

Characteristic.

Yellowish-white, slightly hygroscopic powder. Unstable to light and air. It is soluble in water, alcohol, xloroforme; practically insoluble in ether.

Pharmacological action.
Neuroleptic, antipsychotic, analgesic, antiemetic.

Application.

Psychomotor agitation of various etiologies, accompanied by fear, anxiously, anger, neurotic disorders with increased irritability and sleep disturbances, pain in the trigeminal and facial nerve neuritis, herpes zoster, pruritic dermatoses (in a combination therapy), epilepsy, mental retardation (in a combination therapy), premedication (potentiation of the analgesic action, antihistamine and narcotic drugs).

Contraindications.

Hypersensitivity, arterial hypertension (especially in elderly patients), chronic heart failure in the phase of decompensation, others. cardiovascular and respiratory diseases, diseases of the hematopoietic system, liver failure and kidney, jaundice, zakrыtougolynaya glaucoma, acute infections, epilepsy and Parkinson's, pregnancy, breast-feeding.

Pregnancy and breast-feeding.

Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.

Side effects.

Extrapyramidal disorder with prevalence akinete-hypotonic syndrome, fatiguability, weakness, drowsiness, headache, orthostatic hypotension, tachycardia, thromboembolism, dry mouth, nausea, constipation, abnormal liver function, menstrual disorders, intermenstrual selection, mastalgïya, agranulocytosis.

Cooperation.

Incompatible with MAO inhibitors (increased risk of extrapyramidal disorders due to lower inactivation of the drug in the liver) and antihypertensives (the risk of orthostatic hypotension). It strengthens the central depressive effects of drugs, CNS depressants, reduces the activity of anti-levodopa. Antacids, containing, calcium, magnesium or aluminum, reduce absorption in the gastrointestinal tract (levomepromazin be taken 1 hours before or after 4 hours after ingestion of antacids). Anticholinergic effects increase m-anticholinergic.

Overdose.

Symptoms: depression of consciousness, convulsions, coma.

Treatment: reanimatsionnaya and simptomaticheskaya therapy spetsializirovannom The separated hospital.

Dosing and Administration.

Inside, / m, I /. Mild excitement starts with injecting 25-75 mg, If necessary, up to 200-250 mg in/m or 75-100 mg in/in. Gradually moving to oral ingestion of 50-100 mg/day (optionally up 400 mg). For heavily acute alcoholic psychosis is 50-75 mg in/in, then 150 mg in/m for 5-7 days. In outpatient practice appoint-50.0 12.5 mg/day inside.

Precautions.

It should change injection sites because of possible local tissue reactions (in / m injections are painful). Recommended systematic blood count and liver function tests, in elderly and debilitated patients need to control blood pressure. During the first 3-5 days of treatment after taking levomepromazina irrespective of the dose and method of introduction recommended patient lying 0.5-1 h to prevent ortostaticski collapse. It will be appreciated, that rapid increase in dose, particularly in the elderly or in patients with vascular insufficiency, can develop a drug delirium. Should not be used during the drivers of vehicles and people, skills relate to the high concentration of attention. In the period of treatment required the rejection of alcoholic beverages.