Description of the medicine: Levomepromazin (Levomepromazinum)
LEVOMEPROMAZIN (Levomepromazinum). 2-Methoxy-10 - (3-dimethylamino-2-methylpropyl) -phenothiazine hydrochloride.
Synonyms: Nozinan, Tizercin, Dedoran, Laevomepromazin, Levomazine, Levomepromazini hydrochloridum, Levomepromazine hydrochloride, Levopromazin, Methotrimeprazine, Minozinan, Neozine, Neuractil, Neurocil, Nozinan, Sinogan, Tilerc, etc.
In structure, it differs from chlorpromazine by the presence in the position 2 of the phenothiazine core of a methoxy group (- OCH3) instead of a chlorine atom and an additional methyl group in the alkylamine (branched) chain.
By pharmacological properties it is close to chlorpromazine. The ability to potentiate the effect of narcotic and analgesic substances, and the hypothermic effect in levomepromazine are more pronounced; possesses strong adrenolytic activity, inferior to cholinolytic and antiemetic effect. It has a pronounced antihistamine activity. It has an analgesic effect. Causes relatively strong hypotension.
In relation to the neurotransmitter systems of the brain, it is characterized by a significantly stronger blocking effect on noradrenergic receptors than on dopaminergic ones.
According to the therapeutic effect, levomepromazine is characterized by great activity and the speed of the onset of a sedative effect, which allows it to be used in acute psychoses. Unlike chlorpromazine, it does not increase depression, but it itself has some antidepressant activity. The drug, however, does not have a pronounced timoleptic effect and, with typical endogenous depressions, cannot replace tricyclic or other modern antidepressants.
Indications for the use of levomepromazine are psychomotor agitation of various etiologies, involutional psychoses, the manic stage of manic-depressive psychosis, depressive-paranoid schizophrenia, reactive depression and other psychotic conditions that occur with symptoms of anxiety, fear, motor anxiety. Due to the intense inhibitory effect, it is especially effective in anxiety states, manic oneiroid-catatonic excitation. The high effectiveness of levomepromazine was also noted in alcoholic psychoses.
Levomepromazine is prescribed orally and parenterally (intramuscularly, less often intravenously). Treatment of excited patients begins with a parenteral administration of 0.025-0.075 g of the drug (1-3 ml of a 2, 5% solution); if necessary, increase the daily dose to 0.2 - 0.25 g (sometimes up to 0.35 - 0.5 g) with intramuscular injection and up to 0.075 - 0.1 g when injected into a vein. As the patients calm down, parenteral administration is gradually replaced by ingestion of the drug. Inside appoint 0.05 - 0.1 g (up to 0.3 - 0.4 g) per day. Course treatment begins with a daily dose of 0.025 - 0.05 g (1 - 2 ml of 2, 5% solution or 1 - 2 tablets of 0.025 g), increasing the daily dose by 0.025 - 0.05 g to a daily dose of 0.2 - 0 , 3 g orally or 0.075 - 0.2 g parenterally (in rare cases, up to a daily dose of 0.6 - 0.8 g orally). Towards the end of the course of treatment, the dose is gradually reduced and 0.025-0.1 g per day is prescribed for maintenance therapy.