Sulpiride
Drug class: Typical Antipsychotic
Sulpiride (DOGMATIL)（中文：舒必利）
Common Strengths of Sulpiride Tablet[edit]
Sulpiride are available in the following strengths:
- 50 mg, 200 mg, 400 mg tablets/capsules
Drug Trade Names of Sulpiride Tablet[edit]
Dogmatil
Drug Usage[edit]
Treatment of acute and chronic schizophrenia
Mechanism of Action[edit]
Selective dopamine D2 and D3 receptor antagonist
Route of Administration[edit]
Oral
Dosages[edit]
- Adults: 400 - 1200 mg daily, divided into 2 doses
Side Effects[edit]
| Frequency | Adverse reactions |
|---|---|
| Common | Dizziness |
| Headache | |
| Extrapyramidal side effects such as tremor, dystonia, akathisia, and parkinsonism | |
| Drowsiness | |
| Insomnia | |
| Weight gain or loss | |
| Elevated levels of prolactin which can lead to sexual dysfunction, galactorrhea, amenorrhea, and gynecomastia | |
| Nausea | |
| Vomiting | |
| Nasal congestion | |
| Anticholinergic effects such as dry mouth, constipation, and blurred vision | |
| Impaired concentration | |
| Increased skin sensitivity to sunlight | |
| Serious | Tardive dyskinesia: A potentially irreversible condition characterized by repetitive, involuntary movements of the face and tongue |
| Neuroleptic Malignant Syndrome (NMS): A rare but life-threatening condition marked by muscle stiffness, high fever, confusion, fast heartbeat, and sweating | |
| Arrhythmias, low blood pressure, and in rare cases, cardiac arrest | |
| Severe allergic reactions: Anaphylactic shock, rash, and labored breathing | |
| Oculogyric crisis: Spastic movements that fix the eyes in an upward position | |
| Venous thromboembolism | |
| Increased liver enzymes: Indicating potential liver dysfunction | |
| Aspiration pneumonia |
Pharmacokinetics[edit]
- Time to peak plasma concentration: between 3 to 6 hours after dosing
- Sulpiride undergoes minimal metabolism in the body. About 95% excreted unchanged in urine.
Drug Precautions[edit]
Pregnancy
Use only if benefits outweigh risks. Risk of extrapyramidal/withdrawal symptoms in newborns exposed in 3rd trimester.
Breastfeeding
Excreted in breast milk.
Children and Elderly
- Children: Not recommended for children under 14 years
- Elderly: Lower starting doses recommended
Renal Impairment
Use with caution, dose adjustment may be needed
Monitoring Requirements
- Extrapyramidal symptoms
- Monitor for increased sedation when sulpiride is used with other CNS depressants
- Regular ECG in patients at risk of QT prolongation
- Monitor potassium levels when sulpiride is used with diuretics or stimulant laxatives.
- Complete blood count
- Liver function tests
- Blood pressure
- Eye examinations (long-term use)
Drug Interactions
- Increased sedation with CNS depressants:
- Sedatives and Sleeping Pills: Drugs like nitrazepam, diazepam, and temazepam can increase the sedative effects of sulpiride, leading to enhanced drowsiness and sedation
- Narcotics and Strong Pain Relievers: Medications such as codeine phosphate, morphine, and dihydrocodeine can also amplify CNS depression when taken with sulpiride
- Increased risk of arrhythmias with drugs that prolong QT interval
- Antiarrhythmics: Drugs such as disopyramide, amiodarone, sotalol, and quinidine can increase the risk of cardiac arrhythmias when used with sulpiride
- Antihypertensives and Heart Medications: Clonidine, verapamil, diltiazem, and digitalis may have enhanced effects, potentially leading to hypotension and other cardiovascular issues
- Diuretics and Laxatives: These can lower potassium levels, increasing the risk of cardiac arrhythmias when taken with sulpiride
- Levodopa and Ropinirole: These drugs can antagonize the effects of sulpiride, and their combination should be avoided
- Lithium (increased extrapyramidal effects risk)
- Sucralfate and Magnesium Hydroxide (antacid) can decrease the absorption of sulpiride, reducing its effectiveness. It is recommended to administer sulpiride two hours before these medications
FAQ[edit]
How Should I Take the Tablet?
It can be taken with or without food.
What Should I Avoid While Taking?
Avoid alcohol and activities requiring mental alertness until you know how trifluoperazine affects you.
What Happens if I Miss a Dose?
Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double doses.
