Keep your regular appointments with your doctor. This is so your progress can be checked.
The most common side-effects are feeling sleepy and having a dry mouth.
Your skin may become more sensitive to sunlight than normal. Protect your skin from bright sunlight until you know how your skin reacts, and do not use sunbeds.
|Type of medicine||An antipsychotic medicine|
|Used for||Easing distressing symptoms in palliative care; easing symptoms of schizophrenia|
Levomepromazine is sometimes prescribed for people who are terminally ill to help ease distressing symptoms such as pain, sickness, restlessness, and confusion. It works on the balance of chemical substances acting in the brain. If you (or a family member) have been prescribed levomepromazine for this reason, your specialist or home-care team will be able to give you more information about the treatment.
Levomepromazine is also prescribed to relieve symptoms of schizophrenia. Schizophrenia is a mental health problem which affects your thoughts, feelings or behaviours. Symptoms of schizophrenia include hearing, seeing, or sensing things that are not real, having mistaken beliefs, and feeling unusually suspicious. The rest of this document provides information about levomepromazine when it has been prescribed for schizophrenia.
Before taking levomepromazine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking levomepromazine it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have a heart condition or blood vessel disease.
- If you have liver, kidney, or prostate problems.
- If you have any problems with your breathing.
- If you have any of the following: epilepsy, Parkinson's disease, depression, raised pressure in your eye (glaucoma) or a condition which causes muscle weakness, called myasthenia gravis.
- If you have ever had yellowing of your skin or the whites of your eyes (jaundice) or a blood disorder.
- If you have a tumour on your adrenal gland (a condition called phaeochromocytoma).
- If you have had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take levomepromazine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about levomepromazine and it will also provide you with a full list of the side-effects which you may experience from taking the tablets.
- Take levomepromazine exactly as your doctor tells you to. When you first start taking levomepromazine, your doctor may give you a small dose and then gradually increase it. It is usually prescribed as three doses a day. The directions for taking the tablets will be printed on the label of the pack to remind you about what the doctor said to you.
- Try to get into the habit of taking your doses at the same times of day each day, as this will help you to remember to take them regularly. You can take levomepromazine tablets either before or after meals. Swallow the tablets with a drink of water.
- If you forget to take a dose, leave out the missed dose but make sure that you remember to take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Your treatment will require careful monitoring to make sure that you get the best possible benefit from levomepromazine. Keep your regular doctor's appointments so that your progress can be checked. You will need to have some tests from time to time during the treatment.
- Treatment with levomepromazine for schizophrenia is usually long-term unless you experience an adverse effect. Keep taking the tablets unless your doctor tells you otherwise. Stopping levomepromazine suddenly can cause problems and your doctor may want you to reduce your dose gradually if this becomes necessary.
- Alcohol increases the risk of side-effects from levomepromazine, so it is best avoided.
- If you have diabetes you may need to check your blood glucose more frequently, as levomepromazine may affect the levels of sugar in your blood. Your doctor will advise you about this.
- Levomepromazine can cause your skin to become more sensitive to sunlight than normal. Use a sunscreen that protects against UVA light and has a sun protection factor (SPF), especially in strong sunlight or until you know how your skin reacts. Do not use sunbeds.
- If you are due to have any medical or dental treatment, tell the person carrying out the treatment which medicines you are taking. This is important because levomepromazine may interfere with any anaesthetic you receive.
- If you buy or take any 'over-the-counter' medicines or herbal remedies, please check with a pharmacist that they are suitable for you to take with levomepromazine.
Can levomepromazine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with levomepromazine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common levomepromazine side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sleepy||Do not drive or use tools or machines|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets. If this becomes a problem, speak with your doctor or pharmacist who will be able to recommend a suitable preparation for you|
|Less common levomepromazine side-effects ||What can I do if I experience this?|
|Feeling tired, weak or dizzy||Do not drive or use tools or machines|
|Feeling shaky or restless, unusual or uncontrollable muscle movements||Speak with your doctor about any of these. Your treatment may need adjusting|
|Constipation, changes to your heartbeat||Discuss these with your doctor if troublesome|
Important: if you experience symptoms such as muscle stiffness, a very high temperature, feeling confused, a fast heartbeat and sweating, you should contact your doctor immediately. These can be signs of a rare but serious condition known as neuroleptic malignant syndrome.
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store levomepromazine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Nozinan® tablets; Sanofi, The electronic Medicines Compendium. Dated January 2015.
- British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall