Medication Description: Levomepromazine (Levomepromazinum)
LEVOMEPROMAZIN (Levomepromazinum). 2-Methoxy-10 - (3-dimethylamino-2-methylpropyl) -phenothiazine hydrochloride.
Synonyms: Nosanin, Tizerzin, Dedoran, Laevomepromazin, Levomazine, Lentrama, Levomepromazini hydrochloridum, Levomepromazine hydrochloride, Levopromazin, Methotrimeprazine, Minozinan, Neozine, Neuractil, Neurocylin, Nossin, izin, izin.
The structure differs from aminazine by the presence in position 2 of the phenothiazine core of the methoxyl group (- OCH3) instead of the chlorine atom and the additional methyl group in the alkylamino (branched) chain.
On pharmacological properties close to chlorpromazine. The ability to potentiate the action of narcotic and analgesic substances, and the hypothermic effect on levomepromazine is more pronounced; possesses strong adrenolytic activity; it is inferior to aminazine for anticholinergic and antiemetic effects. It has pronounced antihistamine activity. It has an analgesic effect. Causes relatively strong hypotension.
With respect to neurotransmitter systems, the brain is characterized by a significantly stronger blocking effect on noradrenergic receptors than on dopaminergic ones.
According to the therapeutic effect, levomepromazine is very active and has a rapid onset of sedation, which allows it to be used in acute psychosis. Unlike chlorpromazine, it does not increase depression, but it itself has some antidepressant activity. However, the drug does not have a pronounced thymoleptic effect, and with typical endogenous depressions it cannot replace tricyclic or other modern antidepressants.
Indications for the use of levomepromazine are psychomotor agitation of various etiologies, involutional psychosis, manic stage of manic-depressive psychosis, depressive-paranoid schizophrenia, reactive depression and other psychotic states occurring with signs of anxiety, fear, restlessness. In connection with the intensive braking effect, it is especially effective in anxiety, manic oneiric-catatonic excitation. High efficacy of levomepromazine is also noted in alcoholic psychosis.
Assign levomepromazin inside and parenterally (intramuscularly, less intravenously). Treatment of excited patients begins with 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 administration and to 0.075-0.1 g with the introduction into the vein. As patients are calmed down, parenteral administration is gradually replaced by the drug being taken orally. Inside appoint 0.05 - 0.1 g (up to 0.3 - 0.4 g) per day. The course treatment begins with a daily dose of 0.025-0.05 g (1-2 ml of a 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 inside or 0.075 - 0.2 g parenterally (in rare cases, up to a daily dose of 0.6 - 0.8 g inside). By the end of the course of treatment, the dose is gradually reduced and prescribed for maintenance therapy 0.025 - 0.1 g per day.