Levomepromazine/Methotrimeprazine

PHARMACOLOGY

A neuroleptic phenothiazine which possesses a broad antiemetic effect as well as antipsychotic, anxiolytic, sedative and analgesic properties

Onset of action: 30 minutes
Time to peak: 1-3 h PO, 30-90 minutes SC
Duration of action: 12-24 h
Plasma ½ life: 15-30 h

DOSING

  • 2.5-10 mg tid (maximum 200 mg/24h)
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  • 0.1-04 mg/kg over 24h by SC infusion

UNWANTED EFFECTS

  • Drowsiness
  • Orthostatic hypotension
  • Extrapyramidal effects
  • Dry mouth
  • Urinary retention in elderly

NOTE

This information is drawn from a number of sources (see below). The reader is encouraged to access these and other relevant literature for more detail. As always, sound clinical judgment should be used in individual clinical cases. In particular, it should be remembered that there may be significant variation in the pharmokinetics of a drug resulting from a number of factors, including the individual patient’s metabolism/disease status and how the medication has been formulated.

SOURCES/REFERENCES

  1. Brunton LL, Lazo JS, Parker KL, editors. Goodman and Gilman’s: the pharmacological basis of therapeutics. 11th ed. McGraw-Hill Professional; 2006.
  2. Twycross R, Wilcock A. Palliative care formulary. 3rd ed. Radcliffe Medical Press Ltd; 2008.
  3. Repchinsky C, editor. Compendium of pharmaceuticals and specialties (CPS): the Canadian drug reference for health professionals. 44th ed. Canadian Pharmacists Association; 2009.
  4. Goldman A, Hain R, Liben S. Oxford textbook of palliative care for children. 1st ed. Oxford University Press; 2006.
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