Levomepromazin Neuraxpharm (Levomepromazine Maleate)

Levomepromazine acts on dopaminergic and other neurotransmitter pathways to manage several psychiatric and supportive care conditions.

• Schizophrenia: helps control delusions, hallucinations and thought disorder.
• Psychotic disorders: reduces acute psychotic symptoms and stabilises mood.
• Severe agitation: calms extreme restlessness and aggressive behaviour.
• Nausea and vomiting: alleviates refractory nausea when other treatments fail.
• Pain management in palliative care: provides analgesic and sedative effects for severe cancer‑related pain.

• Levomepromazine maleate exerts its therapeutic effect primarily as a dopamine D2 receptor antagonist, decreasing dopaminergic neurotransmission in the central nervous system. It also blocks histamine H1, muscarinic acetylcholine, and alpha‑adrenergic receptors, contributing to its antihistaminic, anticholinergic, and vasodilatory properties, which together modulate mood, perception, and autonomic functions.

Levomepromazin Neuraxpharm may cause a range of adverse reactions, some of which are more frequently observed than others.

Common Side Effects

• Sedation: drowsiness or reduced alertness.
• Dry mouth: decreased salivation leading to discomfort.
• Constipation: slowed gastrointestinal motility.
• Orthostatic hypotension: dizziness on standing due to blood pressure drop.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: life‑threatening reaction with fever and muscle rigidity.
• Tardive dyskinesia: persistent involuntary movements of the face or limbs.
• Agranulocytosis: severe reduction in white blood cells increasing infection risk.

When prescribing Levomepromazin Neuraxpharm, clinicians should observe several safety measures.

• Monitor blood pressure: watch for hypotension, especially after dose initiation.
• Assess extrapyramidal symptoms: check for early signs of movement disorders.
• Evaluate liver function: adjust use in hepatic impairment.
• Use caution in elderly patients: increased sensitivity to sedation and anticholinergic effects.
• Avoid abrupt discontinuation: taper to reduce withdrawal or rebound symptoms.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Levomepromazin Neuraxpharm can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• CNS depressants (e.g., benzodiazepines, opioids): may enhance sedation and respiratory depression.
• Antihypertensive agents: additive hypotensive effect.
• Anticholinergic drugs: increase risk of severe anticholinergic toxicity.

Moderate Interactions (Monitor Closely)

• CYP1A2 inhibitors (e.g., fluvoxamine): may raise levomepromazine plasma levels.
• Certain antidepressants (e.g., SSRIs): potential for serotonin syndrome.
• Lithium: may potentiate neurotoxic effects, requiring serum level monitoring.