levomepromazine hydrochloride at a glance
Medicine class
Sedating first-generation phenothiazine antipsychotic
Licensed roles
Psychotic or manic agitation, refractory nausea, severe pain and terminal-care distress, depending on the product
Alertness
May cause marked tiredness, dizziness or confusion; do not drive or operate machinery when affected
Alcohol
Avoid alcohol because it can increase sedation, impaired alertness and respiratory depression
What is levomepromazine hydrochloride used for?
Licensed uses differ between formulations.
The oral solution is licensed for restlessness and agitation associated with psychotic disorders and for acute agitation during manic episodes.
The oral solution is licensed as adjunctive treatment for severe or chronic pain.
The oral solution is licensed for refractory nausea unrelated to chemotherapy when other treatments have not controlled symptoms adequately.
The injection is licensed for pain with accompanying restlessness or distress in terminally ill patients.
How does levomepromazine hydrochloride work?
Levomepromazine blocks dopamine, serotonin, histamine, alpha-adrenergic and muscarinic receptors. This can reduce agitation and nausea and produce strong sedation, but also contributes to low blood pressure, dry mouth, constipation and movement-related effects.
levomepromazine hydrochloride preparations and strengths
Oral solution
Route: Oral
Strengths: 5 mg/mL
Injection
Route: Parenteral
Strengths: 25 mg/mL
How to take levomepromazine hydrochloride
Follow the pharmacy label and prescriber's instructions. Measure the oral solution with the supplied oral syringe and bottle adapter, place it into the mouth, rinse the syringe and replace the cap. The injection must be prepared and administered by a healthcare professional.
Do not use a household spoon to measure the oral solution.
Keep the oral solution in its original packaging to protect it from light and use it within three months of opening.
Protect the injection from light.
levomepromazine hydrochloride side effects
Common or expected effects
- Tiredness, sleepiness or reduced alertness
- Dizziness or low blood pressure when standing
- Dry mouth
- Constipation or digestive upset
- Fast heartbeat
- Weight gain
- Restlessness, stiffness, tremor or other movement difficulties
- Blurred vision or difficulty passing urine
Get urgent medical advice
- High temperature, muscle rigidity, sweating or altered consciousness
- Palpitations, fainting or an abnormal heart rhythm
- Fever, sore throat, mouth inflammation or repeated infection suggesting a blood-cell disorder
- Seizure
- Severe constipation with abdominal pain or swelling
- Signs of liver injury, including yellow skin or eyes or dark urine
- A painful swollen leg, or sudden chest pain and breathlessness
- Severe allergic reaction with swelling or breathing difficulty
levomepromazine hydrochloride in pregnancy
Levomepromazine is generally avoided during pregnancy unless a specialist considers it essential. The oral solution should not be used in the first trimester or during the final ten days of pregnancy. Exposure near delivery can cause newborn movement, withdrawal, breathing or feeding problems, so monitoring may be needed.
levomepromazine hydrochloride while breastfeeding
Levomepromazine and its metabolites enter breast milk, and risk to the infant cannot be excluded. The oral-solution information advises stopping breastfeeding if treatment cannot be avoided; the injection information calls for an individual decision balancing breastfeeding benefits against treatment need. Seek specialist advice.
levomepromazine hydrochloride interactions
Check prescribed, non-prescription and herbal products because sedation, low blood pressure, movement effects and heart-rhythm risks can be additive.
Citalopram, escitalopram, hydroxyzine, piperaquine or domperidone
Contraindicated with the selected Nozinan injection because of the risk of dangerous ventricular rhythm disturbances.
Opioids, sleeping medicines, sedatives and other central nervous system depressants
Can substantially increase sedation and respiratory depression.
Alcohol
Common questions about levomepromazine hydrochloride
Answers are fully visible for fast scanning and source review.
Can levomepromazine hydrochloride make me sleepy?
Yes. Strong sedation, tiredness and reduced alertness are characteristic effects, especially early in treatment or with other sedating substances.
Can I drink alcohol while taking levomepromazine hydrochloride?
Avoid alcohol because it can increase sedation, impaired alertness and respiratory depression.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.