Sulpiride

Antipsychotic Drug

Drug class: Typical Antipsychotic

Sulpiride (DOGMATIL)（中文：舒必利）

Common Strengths of Sulpiride Tablet

Sulpiride are available in the following strengths:

• 50 mg, 200 mg, 400 mg tablets/capsules

Drug Trade Names of Sulpiride Tablet

Dogmatil

Drug Usage

Treatment of acute and chronic schizophrenia

Mechanism of Action

Selective dopamine D₂ and D₃ receptor antagonist

Route of Administration

Oral

Dosages

• Adults: 400 - 1200 mg daily, divided into 2 doses

Side Effects

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

• 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.