OralAcute psychosisAdult: 400-800 mg bid. Max: 1.2 g daily. Patients w/ predominantly negative symptoms: 50-300 mg daily. Renal impairment: | CrCl (ml/min) | Dosage Recommendation | | 10-30 | One-third of the usual dose. | | 31-60 | Half the usual dose. |
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Should be taken on an empty stomach. Preferably taken before meals.
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Phaeochromocytoma, concomitant prolactin-dependent tumours (e.g. pituitary gland prolactinomas or breast cancer). Pre-pubertal childn. Combination w/ levodopa.
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Patient w/ history of epilepsy; Parkinson's disease, CV disease. Avoid abrupt withdrawal. Renal impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause somnolence, if affected, may impair ability to drive or operate machinery.
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Insomnia, anxiety, agitation, drowsiness, wt gain, acute dystonia, parkinsonism, akathisia, tardive dyskinesia, QT prolongation, hypotension, bradycardia, GI disorders (e.g. constipation, nausea, vomiting, dry mouth), hyperglycaemia; breast pain, erectile dysfunction, amenorrhoea, gynaecomastia, galactorrhoea. Rarely, allergic reactions, abnormal LFTs, seizures.
Potentially Fatal: Neuroleptic malignant syndrome.
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Symptoms: Generalised convulsions, coma, motor restlessness, tachycardia, slight prolongation of the QT interval, drowsiness, sedation, hypotension, extrapyramidal symptoms. Management: Symptomatic and supportive treatment. Institute close supervision of vital functions including continuous cardiac monitoring until patient recovers. Perform gastric lavage. In case severe extrapyramidal symptoms occur, administer anticholinergic agents.
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Increased risk of arrhythmias w/ cisapride, thioridazine, halofantrine, erythromycin, some antiarrhythmics, pimozide, haloperidol, TCAs, β-blockers, some Ca channel blockers, clonidine, guanfacine, digoxin, K-depleting diuretics, lithium, antimalarials. May enhance effects of antihypertensives and CNS depressants (e.g. sedative H1-antihistamines, narcotics, anaesth, analgesics, barbiturates, benzodiazepines, other anxiolytics, clonidine and derivatives).
Potentially Fatal: Reciprocal antagonism between levodopa and neuroleptics.
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May enhance central effects of alcohol.
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Amisulpride is a substituted benzamide atypical antipsychotic which binds selectively w/ a high affinity to human dopaminergic D2 and D3 receptor subtypes.
Absorption: Absorbed from GI tract. Bioavailability: Approx 48%. Time to peak plasma concentration: 1 hr (initial); 3-4 hr (2nd).
Distribution: Volume of distribution: 5.8 L/kg. Plasma protein binding: Approx 16%.
Metabolism: Limited metabolism.
Excretion: Mainly via urine as unchanged drug. Terminal elimination half-life: Approx 12 hr.
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N05AL05 - amisulpride ; Belongs to the class of benzamides antipsychotics.
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