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[[Category: Drugs]][[Category: typical antipsychotic ]]
[[Category: Drugs]][[Category: Typical Antipsychotic ]]
Drug Class: Antipsychotics, typical ; Antipsychotics, 1st Generation
'''Sulpiride''' (中文:[[      ]])is a typical antipsychotic or 1st Generation antipsychotic medication. It is used in the treatment of psychosis associated with schizophrenia and major depressive disorder. In low dosage, it is used for anxiety and mild depression.


==Pronunciation==
[[:Category: Antipsychotic Drug | '''Antipsychotic Drug''']]
===Sulpiride 200mg===
[[File:Sulpiride 200mg.mp3]]


===Sulpiride 50mg===
'''Drug class: [[:Category: Typical Antipsychotic  | Typical Antipsychotic]]
[[File:Sulpiride 50mg.mp3]]


==Drug Names==
'''Sulpiride (DOGMATIL)'''(中文:[[舒必利]])
{| class="wikitable"
==Common Strengths of Sulpiride Tablet==
!Generic Name 藥名
Sulpiride are available in the following strengths:
!HA Code 藥物代碼
*50 mg, 200 mg, 400 mg tablets/capsules
!Classification藥物分類
 
|-
==Drug Trade Names of Sulpiride Tablet==
|Sulpiride Cap 50 mg
Dogmatil
|SULP19
 
|P1S1S3
==Drug Usage==
|-
Treatment of acute and chronic schizophrenia
|Sulpiride Tab 200 mg
|SULP20
|P1S1S3
|}


==Mechanism of Action==
==Mechanism of Action==
Sulpiride is a selective antagonist at dopamine D2, D3 and 5-HT1A  receptors.
Selective dopamine D<sub>2</sub> and D<sub>3</sub> receptor antagonist
The presumed effectiveness of antipsychotic drugs relied on their ability to block dopamine receptors. This assumption arose from the dopamine hypothesis that maintains that both schizophrenia and bipolar disorder are a result of excessive dopamine activity.
 
==Route of Administration==
Oral
 
==Dosages==
*Adults: 400 - 1200 mg daily, divided into 2 doses


==Dosage==
==Side Effects==
{| class="wikitable"
{| class="wikitable"
!style="text-align: left"| Indication
!style="text-align: left"| Frequency
!style="text-align: left"| Dose
!Adverse reactions
|-
|-
!style="text-align: left"| Schizophrenia with predominantly negative
| rowspan="13" | '''Common
symptoms (flattening of affect, poverty of
| Dizziness
speech, apathy, as well as depression)
|By ''mouth
ADULT:
*200 – 400 mg twice daily.
*Maximum 800 mg per day
ELDERLY or debilitated patients:
*Lower initial dose to be given
*Increased gradually according to response
|-
|-
!style="text-align: left"| Schizophrenia with mainly positive
| Headache
symptoms (hallucinations, delusions,  
|-
incongruity of speech) Respond to higher doses
| Extrapyramidal side effects such as tremor, dystonia, akathisia, and parkinsonism
|By ''mouth
|-
ADULT:  
| Drowsiness
*200 – 400 mg twice daily
|-
*Maximum 2.4 g per day
| Insomnia
ELDERLY or debilitated patients:
|-
*Lower initial dose to be given
| Weight gain or loss
*Increased gradually according to response
|-
| 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
|-
| rowspan="8" | '''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==
*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==
'''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==
'''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.

Latest revision as of 23:22, 31 July 2024


Antipsychotic Drug

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.