Amisulpride
Drug class: Atypical antipsychotic
Amisulpride (SOLIAN)（中文：氨磺必利）
Pronunciation
Amisulpride 100mg
Amisulpride 400mg
Drug Names
| Generic Name 藥名 | HA Code 藥物代碼 | Classification藥物分類 |
|---|---|---|
| Amisulpride Tab 100 mg | AMIS01 | P1S1S3 |
| Amisulpride Tab 200 mg | AMIS02 | P1S1S3 |
| Amisulpride Tab 400 mg | AMIS04 | P1S1S3 |
Common Strengths of Amisulpride Tablet
Amisulpride tablets are available in the following strengths:
- 100 mg, 200 mg, 400 mg tablets
Drug Trade Names of Amisulpride Tablet
Solian
Drug Usage
Amisulpride is used for:
- Treatment of schizophrenia
Mechanism of Action
Amisulpride is a selective dopamine D2 and D3 receptor antagonist. At low doses, it selectively binds to presynaptic dopamine autoreceptors, while at high doses, it
preferentially binds to post-synaptic dopamine receptors. This explains its effectiveness in treating both negative and positive symptoms of schizophrenia.
Route of Administration
- Oral (tablets and oral solution)
Dosages
- Schizophrenia: 400-800 mg/day orally, divided into two doses.
Renal dose based on eGFR:
For severe renal impairment (eGFR <30 mL/min/1.73 m2): Use is not recommended
Side Effects
| Frequency | Adverse reactions |
|---|---|
| Common | Drowsiness/sleepiness |
| Weight gain | |
| Dizziness | |
| Increased appetite | |
| Nausea and vomiting | |
| Constipation | |
| Dry mouth | |
| Blurred vision | |
| Insomnia | |
| Anxiety and agitation | |
| Sexual problems (e.g. difficulty with orgasm) | |
| Excess saliva production | |
| Uncommon | Unexplained infections |
| Fast breathing | |
| Sweating | |
| High blood sugar (increased thirst, hunger, urination) | |
| Breast pain or milk production (in women) | |
| Menstrual changes | |
| Heart rhythm changes (QT prolongation) | |
| Low potassium levels | |
| Neuroleptic malignant syndrome (high fever, muscle rigidity, altered mental state) |
Pharmacokinetics
- Onset Time
- 1 to 4 hours after oral administration; immediate after IV administration.
- Metabolism
- Amisulpride undergoes minimal metabolism
- Elimination
- Amisulpride is primarily eliminated unchanged in the urine
- The elimination half-life is approximately 12 hours
- Duration of Action: Approximately 12 hours based on the elimination half-life, with sustained therapeutic effects for long-term treatment in chronic conditions like schizophrenia.
A person should begin to feel better within six weeks of starting antipsychotic medication.
However, it may take several months before they feel the full benefits.
Drug Precautions
Increased risk in elderly patients
- Should not be used to treat dementia-related psychosis in older adults due to increased risk of stroke and death
- May cause drowsiness, dizziness, and difficulty swallowing in elderly patients, increasing the risk of falls and choking
Pregnancy
- Insufficient data on use during pregnancy to establish risk
Breastfeeding
- Contraindicated during breastfeeding
Children & Adult
- Not recommended for use in children under 18 years old
Renal impairment
- Dose adjustments are necessary for patients with renal insufficiency
QT Prolongation
- Amisulpride can cause dose- and concentration-dependent prolongation of the QT interval, which can lead to serious ventricular arrhythmias like torsades de pointes. It
should be avoided in patients with congenital long QT syndrome and those taking other drugs that prolong the QT interval (e.g., droperidol, ondansetron)
Abrupt Withdrawal
- Should not be stopped abruptly to avoid withdrawal symptoms such as nausea, vomiting, insomnia, and the recurrence of psychotic symptoms
Monitoring Requirements
- Blood glucose monitoring as it may cause elevated blood glucose levels.
- ECG Monitoring: Recommended for patients with preexisting arrhythmias, cardiac conduction disorders, electrolyte imbalances (e.g., hypokalemia, hypomagnesemia), and
congestive heart failure.
Drug Interactions
- Dopamine Agonists: Reciprocal antagonism with dopamine agonists (e.g., levodopa); concurrent use should be avoided.
- Other QT-Prolonging Drugs: Avoid coadministration with other drugs known to prolong the QT interval.
Contraindications
- Pheochromocytoma
- Prolactin-dependent tumors (e.g., prolactinoma, breast cancer)
- Movement disorders (e.g., Parkinson's disease, dementia with Lewy bodies)
FAQ
How Should I Take the Tablet?
- Swallow the tablets whole with a full glass of water. Do not chew, crush or break the tablets
What should I avoid while taking?
- Amisulpride may cause drowsiness, dizziness or blurred vision, especially when you first start taking it. Avoid driving, operating machinery or doing activities that
require alertness until you know how the medication affects you.
- Do not stop taking amisulpride suddenly without consulting your doctor. Abrupt withdrawal can cause unpleasant side effects or a return of symptoms.
- Be cautious about getting overheated or dehydrated, as amisulpride can affect your body's ability to regulate temperature.
What Happens if I Miss a Dose?
- Answer not provided in the given information. If you miss a dose, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the
missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
