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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
|-
|Sulpiride Cap 50 mg
|SULP19
|P1S1S3
|-
|Sulpiride Tab 200 mg
|SULP20
|P1S1S3
|}


==Mechanism of Action==
==Drug Trade Names of Sulpiride Tablet==
Sulpiride is a selective antagonist at dopamine  D2, D3 and 5-HT1A  receptors.
Dogmatil
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.


==Dosage==
==Drug Usage==
{| class="wikitable"
Treatment of acute and chronic schizophrenia
!style="text-align: left"| Indication
!style="text-align: left"| Dose
|-
!style="text-align: left"|
Schizophrenia with predominantly negative


symptoms(flattening of affect, poverty of
==Mechanism of Action==
Selective dopamine D<sub>2</sub> and D<sub>3</sub> receptor antagonist
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


symptoms(hallucinations, delusions,
==Route of Administration==
Oral


incongruity of speech) Respond to higher doses
==Dosages==
|By ''mouth
*Adults: 400 - 1200 mg daily, divided into 2 doses
ADULT:  
*200 – 400 mg twice daily
*Maximum 2.4 g per day
ELDERLY or debilitated patients:
*Lower initial dose to be given
*Increased gradually according to response
|}


==Side Effects==
==Side Effects==
Most serious and/or frequently occurring adverse effects of sulpiride include the following:
{| class="wikitable"
{| class = "wikitable"
!style="text-align: left"| Frequency
!style="text-align: left"| Endocrine disorders
!Adverse reactions
|
*Common: hyperprolactinaemia (elevated plasma levels of the hormone prolactin, which in turn lead to galactonrrhea, amornorrhea, gynecomastia etc)
|-
|-
!style="text-align: left"| Nervous system
| rowspan="13" | '''Common
|
| Dizziness
Common:
|-
*Sedation or drowsiness
| Headache
*Extrapyramidal side effects  
|-
-Tremor
| Extrapyramidal side effects such as tremor, dystonia, akathisia, and parkinsonism
 
|-  
-Akathisia – a sense of inner restlessness that cannot stay still
| Drowsiness
 
|-
-Parkinsonism
| Insomnia
*Anticholinergic side-effects such as:
|-  
-Dry mouth
| Weight gain or loss
 
|-  
-Constipation
| Elevated levels of prolactin which can lead to sexual dysfunction, galactorrhea, amenorrhea, and gynecomastia
 
|-  
-Blurred vision
| Nausea
Uncommon:
|-  
*Hypertonia
| Vomiting
*Dyskinesia
|-  
Rare:
| Nasal congestion
*Oculogyric crisis
|-
Not known:
| Anticholinergic effects such as dry mouth, constipation, and blurred vision
*Neuroleptic malignant syndrome
|-
*Convulsion
| Impaired concentration
*Tardive dyskinesia
|-
| 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
|-
|-
!style="text-align: left"| Metabolism disorders
| Arrhythmias, low blood pressure, and in rare cases, cardiac arrest
|
Not known:
*Hyponatraemia
*Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
|-
|-
!style="text-align: left"| Cardiac disorders
| Severe allergic reactions: Anaphylactic shock, rash, and labored breathing
|
Rare:
*Ventricular arrhythmia
*Ventricular fibrillation, or tachycardia
Not known:
*Electrocardiogram QT prolonged
|-
|-
!style="text-align: left"| Vascular disorder
| Oculogyric crisis: Spastic movements that fix the eyes in an upward position
|Uncommon: orthostatic hypotension
|-
|-
!Gastrointestinal disorder
| Venous thromboembolism
|
Common: constipation
Uncommon: saliva hypersecretion
|-
|-
!style="text-align: left"| Breast disorder
| Increased liver enzymes: Indicating potential liver dysfunction
|Common: breast pain, galactorrhoea
|-
|-
!style="text-align: left"|  
| Aspiration pneumonia
|
Common:
*weight gain
|}
|}


==Pharmacokinetics==
==Pharmacokinetics==
{|class="wikitable"
*Time to peak plasma concentration: between 3 to 6 hours after dosing
!style="text-align: left"| Oral bioavailability
*Sulpiride undergoes minimal metabolism in the body. About 95% excreted unchanged in urine.
|Sulpiride is readily absorbed after oral doses.
 
|-
==Drug Precautions==
!style="text-align: left"| Onset of action
'''Pregnancy
|Peak plasma concentrations are reached 3 – 6 hours after an oral dose.
 
|-
Use only if benefits outweigh risks. Risk of extrapyramidal/withdrawal symptoms in newborns exposed in 3rd trimester.
!style="text-align: left"| Metabolism
 
|It is metabolized in the liver
'''Breastfeeding
|-
 
!style="text-align: left"| Elimination half-life
Excreted in breast milk.
|
 
It is excreted in the urine and faeces.
'''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?


The elimination half-life is approximately 8 hours.
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.