Neurocil Ampullen (Levomepromazine Hydrochloride)

Levomepromazine Hydrochloride is a phenothiazine antipsychotic used in several clinical settings.

• Schizophrenia: reduces psychotic symptoms and stabilises mood.
• Severe agitation: calms acute agitation in psychiatric emergencies.
• Nausea and vomiting: controls refractory nausea, especially in oncology or palliative care.
• Palliative‑care symptom control: provides sedation and analgesia for refractory pain and distress.

• Levomepromazine Hydrochloride exerts its therapeutic effect primarily by antagonising dopamine D2 receptors, decreasing dopaminergic neurotransmission. It also blocks histamine H1, muscarinic acetylcholine and alpha‑adrenergic receptors, contributing to its sedative, anti‑emetic and antihistaminic properties. The combined receptor blockade modulates central pathways involved in psychosis, agitation, nausea and pain perception, reducing excitatory signalling and producing calming effects.

Levomepromazine Hydrochloride may cause a range of adverse reactions.

Common Side Effects

• Drowsiness: excessive sleepiness or fatigue.
• Dry mouth: reduced salivary secretion.
• Constipation: slowed gastrointestinal motility.
• Orthostatic hypotension: dizziness on standing.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: life‑threatening hyperthermia and rigidity.
• Tardive dyskinesia: persistent involuntary movements.
• Severe hypotension or cardiac arrhythmias.
• Agranulocytosis or seizures: rare but potentially fatal events.

When using Levomepromazine Hydrochloride, several safety considerations apply.

• Dose adjustment: start low and titrate slowly in elderly or patients with hepatic impairment.
• Monitoring: regularly assess blood pressure, ECG and signs of extrapyramidal symptoms.
• Contraindications: avoid in individuals with known hypersensitivity to phenothiazines.
• Pregnancy and lactation: prescribe only if benefits outweigh potential risks.
• Store at below 25°C: keep in the original carton, protect from light and moisture.

Levomepromazine Hydrochloride can interact with a variety of medicines.

Major Interactions (Avoid)

• Other dopamine antagonists: additive central nervous system depression.
• Anticholinergic drugs: increased anticholinergic burden.
• QT‑prolonging agents: heightened risk of cardiac arrhythmia.
• MAO inhibitors: risk of severe hypotension.

Moderate Interactions (Monitor Closely)

• CNS depressants (e.g., benzodiazepines, opioids): enhanced sedation and respiratory depression.
• Alcohol: increased drowsiness and impaired coordination.