levomepromazine maleate at a glance
Medicine class
First-generation phenothiazine antipsychotic
Licensed roles
Schizophrenia; adjunctive relief of pain and accompanying distress in terminal illness
Important practical effect
Marked sleepiness and postural low blood pressure can occur, particularly early in treatment
Administration
Swallow the tablet with water and avoid alcohol
What is levomepromazine maleate used for?
The selected tablet is licensed for schizophrenia and adjunctive pain relief in terminal illness. Specialist teams also use levomepromazine outside its licence as an anti-sickness treatment.
Schizophrenia, as an alternative to chlorpromazine when reducing psychomotor activity is particularly desirable.
Adjunctive relief of pain and accompanying distress in terminal illness.
Prevention or treatment of nausea and vomiting under specialist or palliative-care supervision; this is outside the selected tablet’s licence.
How does levomepromazine maleate work?
Levomepromazine reduces dopamine signalling and also has antihistamine, anti-adrenaline and anti-sickness activity. These actions contribute to its antipsychotic effects, pronounced sedation, reduced alertness and tendency to lower blood pressure.
levomepromazine maleate preparations and strengths
Tablet
Route: Oral
Strengths: 6 mg, 6.25 mg, 25 mg, 50 mg
How to take levomepromazine maleate
Take levomepromazine exactly as prescribed. Swallow the tablet whole with water. Avoid alcohol, and do not drive or operate machinery if drowsy, confused, dizzy, disorientated or light-headed.
Rise slowly from sitting or lying because low blood pressure can cause faintness.
Tell healthcare professionals, including dentists, that you take levomepromazine.
Keep tablets in their original container, protected from light and out of children’s reach.
levomepromazine maleate side effects
Common or expected effects
- Sleepiness or sedation
- Dry mouth
- Weakness
- Dizziness or faintness from postural low blood pressure
- Difficulty regulating body temperature, including heat stroke in hot or humid conditions
Get urgent medical advice
- Severe allergic reaction
- Neuroleptic malignant syndrome: fever, muscle rigidity, confusion, sweating or unstable pulse or blood pressure
- Heart-rhythm disturbance, which may cause palpitations, dizziness or fainting
- Severe infection associated with reduced white blood cells
- Seizures or significant abnormal movements
- Blood clot symptoms, including a painful swollen leg, chest pain or breathlessness
- Severe constipation or paralytic ileus with abdominal pain and swelling
- Jaundice or other signs of liver injury
levomepromazine maleate in pregnancy
Safety information is limited. The selected product information advises avoiding levomepromazine during pregnancy unless a clinician considers it necessary. Exposure near delivery may cause newborn movement, withdrawal, breathing or feeding problems requiring monitoring. Do not stop established treatment without speaking to the prescriber.
levomepromazine maleate while breastfeeding
Small amounts enter breast milk, and risk to the infant cannot be excluded. An individual decision is needed between breastfeeding and treatment, considering their respective benefits; seek specialist advice.
levomepromazine maleate interactions
Check all prescribed, over-the-counter and herbal products because levomepromazine has important cardiac, sedative and anticholinergic interactions.
Citalopram, escitalopram, hydroxyzine, piperaquine or domperidone
The selected product lists these combinations as contraindicated because they increase the risk of serious ventricular rhythm disturbance.
Other QT-prolonging medicines
Antiarrhythmics, some antidepressants, antipsychotics, antimicrobials and methadone can further increase arrhythmia risk and may require avoidance or ECG monitoring.
Alcohol, sedatives and barbiturates
Sedation, reduced alertness and central nervous system or respiratory depression may increase.
Common questions about levomepromazine maleate
Answers are fully visible for fast scanning and source review.
What is levomepromazine maleate used for?
The selected UK tablet is licensed for schizophrenia and as an adjunct for pain with accompanying distress in terminal illness. Specialist teams also use it outside its licence for nausea and vomiting.
Does levomepromazine maleate make you sleepy?
Sleepiness and sedation are very common and may be most noticeable early in treatment. Alcohol and other sedatives can make this worse.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.