Drug Data

Generic Name
levomepromazin
e

Trade Name
Nazinan

Patients Dose
N/A

Minimum
Dose
PO:100200mg/day

Maximum
Dose
PO:1g/day

Contents
levomeprazine

Availability
and color

Tablets: 2mg, 5mg

Elixir: 2mg/5ml
Routes of
administratio
n
PO,IV,IM

Classificatio
n
Therapeutic:
Antipsychotic
Pharmacolo
gic
Phenothiazine
Pregnancy
Category
C

Mechanism of
Action
Levomepromazine
is a phenothiazine
with CNS
depressant, adrenergic-blocking,
antimuscarinic,
antihistaminic and
analgesic activity. It
acts by blocking
dopamine receptors
in the mesolimbic
dopaminergic
system.
Pharmacokine
tics
A: Incomplete oral
bioavailability
because of firstpass metabolism.
D: Dist. Volume 30
l/kg/. Is lipophilic
and crosses bloodbrain barrier, be
placenta and enters
breast milk.
M&E: Metablized by
liver to sulfoxide, a
glucumide and
demethylated
metabolite. Drug
elimination is slow.
Metabolism found in
feces and urine.
(1%unchanged)
Onset
IM: 1hr
PO,IV: unknown
Peak
PO: 1-4hrs
IM: 30-90 mins.
Duration
IM: 2-4hrs.
PO,IV: unknown

Drug Half Life

15-30 hrs.

Indication

General
Indications

Treatment of
psychoses:
schizophrenia,
manic phases of
bipolar disorder;
Treatment of
agitated depression.
Treatment of
nausea and
insomnia. Easing
distressing
symptoms in
palliative care

Patients
Actual
Indication

Contraindications
Comatose state, severe
CNS depression,
phaeochromocytoma,
blood dyscrasia.
Precaution
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.
.Drug interaction
-drug to drug
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.

Adverse
Nursing
Reaction
Responsibilities
CNS:
Before
extrapyramidal
1. Assess patients
effects,
cardia, hepatic
dizziness,
and renal function.
seizure,
2. Assess patients
headache,
mental status.
drowsiness,
3. Confirm
neuroleptic
medication from
malignant
doctors orders.
syndrome,
4. Assess other
interference
medications taken
with
by patient.
temperature
5. Assess patients
regulation.
LOC.
CVD:
Hypotension,
During
orthostatic
hypotension,
1. Confirm patients
tachycardia, QT
identity.
prolongation.
2. Administer
Derm:
medication at the
photosensitivity.
right prescribed
Endo:
route.
gynecomastia,
3. Do not go over the
weight gain,
recommended
irregular
dose.
menstruation,
4. Practice aseptic
changes in
technique.
libido.
5. Administer
GI: constipation,
medication before
or after meals.
N/V
After
GU: urinary
retention,
1. Observe proper
ejaculatory
documentation of
dividers,
administered
incontinence
medication.
polyuric
2. Ensure that
priaprism.
patient has fully
Hemat: blood
swallowed oral
dyseralics,
form of
jaundice,
medication.
hepatotoxicity
3. Observe patients
behavior closely
for atleast 15-30
minutes after
administration.
4. Monitor patients
V/S throughout
the therapy.

 Reduced effects
ofbromocriptine, guane
thidine,
guanadrel, levodopa.
Increased neurotoxicity
with lithium (rare).
Reduced serum levels
with phenytoin or
increased phenytoin
toxicity.
Increased serum
concentrations with
propranolol,
sulfadoxinepyrimethamine.
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, trihe
xyphenidyl,biperiden,
TCAs, antihistamines,
disopyramide.
Source:
MIMS(2013).MIMS.USA:levomepramizine.MIMS. Retrieved on June 19, 2013 from
http://www.mims.com/usa/drug/info/levomepromazine/?type=full&mtype=generic#Actions

5.

Instruct patient to
rest after
administration.