sulvorid tablet uses indication
Sulvorid (Levosulpiride)
25mg &50mg Tablets
DESCRIPTION
Sulvorid (Levosulpiride) is a substituted benzamide antipsychotic which is reported to be a selective antagonist of central dopamine (D, Ds and D.) receptors. Chemically it is N-[(2S)-1-Ethyipyrrolidin-2-yl]methyl)-2-methoxy-5-sulfamoylbenzamide. Its molecular formula is C1s H23 N O S.
COMPOSITION
Sulvorid (Levosulpiride) is available for oral administration as:
1. Sulvorid Tablets 25mg
Each tablet contains: Levosulpiride MS...25mg
2. Sulvorid Tablets 50mg
Each tablet contains: Levosulpiride MS...50mg
CLINICAL PHARMACOLOGY Mechanism of Action
Levosulpiride is a medication that inhibits the effects of dopamine in the brain and spinal cord. By doing so, it helps to control the digestive system's movements.
Action on dopamine autoreceptors:
• The liking of levosulpiride for the D2 receptor is as it were 2-3 times more prominent than that for the Da receptor. This contrasts with typical antipsychotics, which are 10-20 times more potent at D2 than at Da.
• Levosulpiride specifically squares dopamine autoreceptors, which are found on presynaptic neurons. The dopamine autoreceptor includes a more noteworthy affinity for ligands than the dopamine postsynaptic receptor, as a result Da ligands appear more noteworthy inclination for autoreceptors.
• Levosulpiride increases dopamine neurotransmission by increasing the presynaptic synthesis and release of dopamine. Usually since it pieces the dopamine autoreceptor, which restrains the presynaptic union and discharge of dopamine.
• A small amount of levosulpiride is usually between 50 to 200 milligrams per day. Levosulpiride can offer assistance with the terrible considerations and distraction that come with schizophrenia. It can moreover offer assistance with being pitiful and having physical indications without any clear cause.
Action on dopamine postsynaptic receptors:
In high doses, levosulpiride also blocks Dz dopamine postsynaptic receptors. The result is decreased dopaminergic neurotransmission. In humans high doses of levosulpiride generally refer to doses of 400-300mg/day.-At these doses, levosulpiride is therapeutic for positive symptoms of schizophrenia.
Indirect action on adrenergic receptors: Levosulpiride down directs cortical beta adrenoceptors. This activity may contribute to the upper activity of the medicate.
Absence of binding to other receptors: Levosulpiride does not block 5-HTz serotonergic and H.Histaminic receptors do not often cause side effects like feeling tired, wanting to eat more, or gaining weight.
• Levosulpiride does not square alpha-1 adrenergic receptors, and is subsequently impossible to cause the hypotension impacts watched with other drugs that do.
• Levosulpiride does not piece muscarinic cholinergic receptors, and is hence impossible to cause unfavorable impacts such as dry mouth, obscured vision, impeded convenience clogging and trouble in passing urine.
Pharmacokinetics:
Levosulpiride is slowly absorbed from the gastrointestinal tract, bioavailability is about 30% evosulpiride is less than 40% bound to plasma proteins. Top plasma concentration happens after 3 hours and it encompasses a plasma half life of approximately 9.7 hours. It is mostly eliminated by the kidneys in the urine, chiefly as an unchanged drug.
INDICATIONS
Sulvorid tablets are shown for verbal organization: Sulvorid 25mg tablets are shown for the treatment of the taking after:
• Gastroesophageal reflux disease.
• Irritable bowel syndrome.
• Dyspeptic syndrome due to delayed gastric emptying linked to organic factor (diabetic gastro paralysis, neoplasia, etc.) and/or to functional disorder.
• Essential cephalgia.
• Vertigo of a central and/or peripheral origin.
Sulvorid 50mg tablets are indicated for the treatment of the following:
✓ Endogenous and reactive depressive states.
✓ Somatic disorder.
✓ Acute and chronic schizophrenia especially recommended for negative symptoms (after disorder)
ADVERSE REACTIONS
The opposing impacts of levosulpiride (sulvorid) are particularly checked inside the elderly and join sadation and hypotension as well as shinning dyskinesia. Very rarely were observed psychomotor excitation, autonomic disturbance, allergic reactions and extrapyramidal effects such as tremors, dystonia. The changes are small and can be undone.
. Some disorders, such as amenorrhea, gynecomastia, galactorrhoea, hperprolactinemia and changes in libido observed in particular cases are attributable to reversible effects of levosulpiride in the functionality of the hypothalamus-pituitary-gonadal axis which are similar to that known in many neuroleptics. Ventricular arrhythmias such as torsades de pointes, ventricular tachycardia, ventricular fibrillation arrest may also be observed.
CONTRAINDICATIONS
Sulvorid is contraindicated in the following conditions:
People who are allergic to levosulpiride or any part of this medicine should not take it.
In epilepsy, in manic conditions and in the manic stages of manic-depressive psychosis. Patients with hyperprolactinemic tendency, mammary dysplasia malignant mastopathy. Patients affected by pheochromocytoma as it may cause a hypertensive crisis, probably due to release of catecholamine from the tumor. in the presence of gastrointestinal bleeding, mechanical. Pregnant women and nursing mothers. Pediatric population
DOSAGE AND ADMINISTRATION
The usual adult oral dose of Sulvorid is given before meals as mentioned in the following table:
Geriatric Use:
The dosage may be progressively lowered. In treating aged patients the dosage must be carefully established by the physician who must consider a possible reduction in the dosage mentioned above.
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PRECAUTIONS
Sulvorid should be used with care in the following conditions:
• If you take a lot of levosulpiride, you might feel very sleepy, numb or find it hard to move properly. So, don't drive or use heavy machinery if you feel this way.
• If held to be essential for re-treament with antipsychotics, the patient should be carefully monitored.
• Avoid concomitant therapy with other neuroleptics. Lse with caution in patients with cardiovascular disease or prolongation.
• Avoid the simultaneous consumption of alcohol.
DRUG INTERACTIONS
General:
When neuroleptics are administered concomitantly with drugs that prolong the QT risk cardiac arhythmias increase.
• Not to be administered concomitantly with the drugs that cause electrolyte disturbance. Antacids: The concomitant use of levosulpiride with therapeutic doses of sucralfate or an antacid containing aluminium and magnesium hydroxide may reduce mean oral bioavailability of levosulpiride.
Anticholinergics, opiates or pain relieving specialists: The impact of levosulpiride on the gastrointestinal motility may be contradicted by anticholinergics, opiates or pain relieving specialists.
Psychopharmacological agents:
Concomitant use with other psychopharmacologic agents require particular care and vigilance by the physician, in order to avoid any unexpected side effect or drug-drug interaction.
OVERDOSAGE:
In internal medicine neither extrapyramidal nor sleep disturbances have ever been observed, which may eventually occur at very high doses. Interrupting the therapy or reducing the doses depending on physician's judgement will be sufficient in this case.
INSTRUCTIONS
Store below 30°C. Protect from light and moisture. Make sure kids can't get to any medicine. You can only buy it if a doctor gives you a prescription.
PRESENTATIONS
Sulvond (Levosulpiride) Tablets 25mg are available in alu-alu pack of 20's. Sulvorid (Levosulpinide) Tablets 50mg are available in alu-alu pack of 20's.
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