Last update: May 13, 2019

Levosulpiride

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

The L-enantiomer of sulpiride with similar characteristics, effects and pharmacokinetic properties as sulpiride (Gupta 2007, Mucci 1995).
Sulpiride is an antipsychotic, antidepressant, antiemetic, prokinetic and selective dopamine antagonist that increases prolactin levels.

Levosulpiride is sold in few countries and is more commonly used as a prokinetic than an antipsychotic in functional gastrointestinal disorders such as dyspepsia, gastric pain and nausea at doses lower than those of sulpiride (Singh 2015, Lozano 2007, Salvat 2007, Corazza 1996, Mangiameli 1994).
Oral administration in three doses a day.

Since the last update we have not found published data on its excretion in breastmilk, but its pharmacokinetics are similar to that of sulpiride (Gong 2014), which is excreted in possibly significant amounts in breastmilk.

Like sulpiride, it also has a low oral bioavailability (Xu 2015, Salvat 2007), which hinders its transfer into infant plasma from breastmilk, except in premature infants and the immediate neonatal period when there may be greater intestinal permeability.

It presents potentially serious side effects such as parkinsonism and other abnormal movements (Mishra 2019, Desai 2018, Choudhury 2017, Mathew 2017, Shin 2009), neuroleptic malignant syndrome, prolactin increase and galactorrhea (Kuchay 2017, Lozano 2007, Mucci 1995), so that its use as a prokinetic and as a galactogogue is very debatable.

For more details please consult the entry for sulpiride.


See below the information of this related product:

Alternatives

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Other names

Levosulpiride is also known as


Levosulpiride in other languages or writings:

Group

Levosulpiride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Levosulpiride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 23,4 %
Molecular weight 341 daltons
Protein Binding 40 %
VD 2,1 - 2,5 l/Kg
Tmax 3 hours
T1/2 4,3 - 7 hours

References

  1. Mishra D, Niranjan V, Kumar P. Levosulpiride-Induced Restless Leg Syndrome: A Case Report. Psychosomatics. 2019 Jan - Feb;60(1):80-82. Abstract
  2. Desai D, Gupta K, Kumar R, Biswas A. Levosulpiride-induced neuroleptic malignant syndrome in rheumatoid arthritis. BMJ Case Rep. 2018 Aug 11;2018. pii: bcr-2018-224679. Abstract
  3. Mathew T, Nadimpally US, Prabhu AD, Nadig R. Drug-induced Parkinsonism on the rise: Beware of levosulpiride and its combinations with proton pump inhibitors. Neurol India. 2017 Jan-Feb;65(1):173-174. Abstract
  4. Kuchay MS, Mithal A. Levosulpiride and Serum Prolactin Levels. Indian J Endocrinol Metab. 2017 Mar-Apr;21(2):355-358. Abstract
  5. Choudhury S, Chatterjee K, Singh R, Shubham S, Trivedi S, Chatterjee S, Kumar H. Levosulpiride-induced Movement Disorders. J Pharmacol Pharmacother. 2017 Oct-Dec;8(4):177-181. Abstract
  6. Singh H, Bala R, Kaur K. Efficacy and tolerability of levosulipride, domperidone and metoclopramide in patients with non-ulcer functional dyspepsia: a comparative analysis. J Clin Diagn Res. 2015 Apr;9(4):FC09-12. Abstract
  7. Xu M, Zhou Y, Ni Y, He X, Li H, Sattar H, Chen H, Li W. Tolerability and Pharmacokinetic Comparison of Oral, Intramuscular, and Intravenous Administration of Levosulpiride After Single and Multiple Dosing in Healthy Chinese Volunteers. Clin Ther. 2015 Nov 1;37(11):2458-67. Abstract
  8. Gong C, Agbokponto JE, Yang W, Simpemba E, Zheng X, Zhang Q, Ding L. Pharmacokinetics of levosulpiride after single and multiple intramuscular administrations in healthy Chinese volunteers. Acta Pharm Sin B. 2014 Oct;4(5):402-7. Abstract
  9. Shin HW, Kim MJ, Kim JS, Lee MC, Chung SJ. Levosulpiride-induced movement disorders. Mov Disord. 2009 Nov 15;24(15):2249-53. Abstract
  10. Salvat. Levosulpirida (Levogastrol). Ficha tecnica. 2007 Full text (in our servers)
  11. Sparsh Gupta, Gobind Rai Garg, Sumita Halder, Krishna Kishore Sharma. Levosulpiride: A Review. Delhi Psychiatry Journal 2007; 10(2):144-146 Full text (link to original source) Full text (in our servers)
  12. Lozano R, Concha MP, Montealegre A, de Leon L, Villalba JO, Esteban HL, Cromeyer M, García JR, Brossa A, Lluberes G, Sandí EI, Quirós HB. Effectiveness and safety of levosulpiride in the treatment of dysmotility-like functional dyspepsia. Ther Clin Risk Manag. 2007 Mar;3(1):149-55. Abstract
  13. Corazza GR, Biagi F, Albano O, Bianchi Porro G, Cheli R, Mazzacca G, Miglio F, Naccarato R, Quaglino D, Surrenti C, Verme G, Gasbarrini G. Levosulpiride in functional dyspepsia: a multicentric, double-blind, controlled trial. Ital J Gastroenterol. 1996 Jul-Aug;28(6):317-23. Abstract
  14. Mucci A, Nolfe G, Maj M. Levosulpiride: a review of its clinical use in psychiatry. Pharmacol Res. 1995 Feb;31(2):95-101. Abstract
  15. Mangiameli A, Brogna A, Catanzaro R, Sofia M, Blasi A. [Levosulpiride versus domperidone in the treatment of functional dyspepsia]. Clin Ter. 1994 Feb;144(2):107-14. Italian. Abstract

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