Indications 

The proficient handling of terminal illnesses, especially in cases characterized by symptoms such as restlessness, anxiety, agitation, emotional perturbation, pain, nausea, and vomiting, is paramount. Furthermore, within psychiatry, particularly in schizophrenia management, a need arises to mitigate psychomotor hyperactivity for therapeutic purposes. 

Uses and Dosage 

For adult ambulatory patients, the recommended initial oral dose of levomepromazine should be carefully administered, typically 25 to 50 mg, distributed into three separate doses. Emphasizing nocturnal administration is advisable to minimize daytime sedation. Subsequently, the dosage may be gradually escalated to achieve an optimal therapeutic level while vigilance is maintained for sedation and other potential side effects. 

In the case of bedridden patients, an initial daily oral dosage between 100 to 200 mg is suggested, divided into three doses, with the possibility of a gradual increment of up to 1 g daily if deemed necessary for the individual’s condition. Once the patient attains stability, a reasonable effort should be made to taper the dosage to an appropriate maintenance level while ensuring continued efficacy. 

Children exhibit heightened sensitivity to the hypotensive and sedative effects of levomepromazine. Therefore, do not exceed a total daily oral dosage of 40 mg. A 10-year-old child’s adequate daily intake should fall within the 15 to 20 mg range. Careful consideration of these dosage guidelines is essential to ensure the well-being of pediatric patients. 

Side Effects 

Mild Side Effects

Notify your doctor or pharmacist if you experience these: 

• Drowsiness 
• Weakness 
• Dry mouth 

Note: These effects are typically temporary and mild. 

Severe Side Effects

Immediate medical attention required (Contact your doctor or pharmacist if any of these occur): 

• Dizziness, feeling faint, or loss of alertness 
• Skin irritation or rash, especially after sun exposure, leading to burning 
• Fever, mouth or throat ulcers, sore throat, or any signs of infection 
• Tremors or shaking muscle stiffness 
• Severe constipation, potential bowel obstruction 
• Unwanted or persistent erections 
• Irregular or fast heartbeat 
• Symptoms indicative of high blood sugar levels, such as excessive thirst, increased appetite with weight loss, fatigue, and excessive urination 
• Symptoms of jaundice, such as yellowing of the skin and eyes 
• Unusual temperature sensations, feeling extremely hot or cold 
• Hormone imbalance leading to breast enlargement and impotence in men or abnormal breast milk secretion in non-breastfeeding women, loss of menstrual periods, and frigidity 
• Fatigue, weakness, confusion, muscle aches, stiffness, or impaired muscle function, possibly due to low sodium levels in the blood 
• Feeling unwell, confused, weak, nauseous, loss of appetite, or irritability, perhaps indicating a condition known as Syndrome of Inappropriate Anti-Diuretic Hormone Secretion (SIADH) 
• Feelings of confusion, indifference, or nervousness 

Please promptly report any of these symptoms to your healthcare provider or pharmacist. 

Cautions 

Inform your healthcare provider or pharmacist about any medical conditions you currently have or have had in the past, particularly if you’ve experienced any of the following: 

• Heart disease 
• Liver disease 
• Urinary or prostate problems 
• Elevated intraocular pressure (glaucoma) 
• A history of low white blood cell count (agranulocytosis) 
• Kidney disease 
• Hypothyroidism (an underactive thyroid gland leading to a decreased metabolism) 
• Phaeochromocytoma, an uncommon adrenal gland tumor located near the kidneys 
• Muscle-related disorders resulting in symptoms such as drooping eyelids, double vision, speech and swallowing difficulties, and occasional muscle weakness in the limbs (myasthenia gravis) 
• Slow or irregular heartbeats, palpitations, or a family history of these cardiac issues 

Providing this medical history information is essential to ensure your safety and optimize the management of your healthcare needs.