Sulpiride

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Dogmatil, Meresasul; Belgium: Docsulpiri, Dogmatil, Sulpiride; Czech Republic: Dogmatil, Prosulpin, Sulpirol; Denmark: Dogmatil; Estonia: Betamacks; Finland: Suprium; France: Dogmatil, Sulpiride, Synedil; Germany: Arminol, Dogmatil, Meresa, Meresasul, Psychonerton, Sulp, Sulpi, Sulpirid, Sulpivert, Vertigo-Meresa, Vertigo-Neogama; Greece: Calmoflorine, Darleton, Dogmatyl, Noneston, Restful; Hungary: Depral; Ireland: Dolmatil; Italy: Championyl, Dobren, Equilid; Latvia: Betamaks; Lithuania: Eglonyl, Prosulpin; Luxembourg: Dogmatil, Meresa, Sulpiride; Malta: Guastil; Netherlands: Dogmatil; Poland: Sulpiryd; Portugal: Dogmatil; Romania: Eglonyl; Slovakia: Sulpirid; Slovenia: Eglonyl; Spain: Digton, Dogmatil, Guastil, Psicocen, Tepavil; UK: Dolmatil, Sulpiride, Sulpor.

Latin America

Argentina: Vipral; Brazil: Dogmatil, Equilid; Mexico: Ekilid, Pontiride, Rimastine.

Asia

Japan: Abilit, Betamac, Coolspan, Dogmatyl, Margenol, Miradol, Nichimal, Pyrikappl, Seeglu, Skanozen, Sulpiride, Youmathyle.

Drug combinations

Sulpiride and Alprazolam

Sulpiride and Clorazepate

Sulpiride and Diazepam

Chemistry

Sulpiride: C~15~H~23~N~3~O~4~S. Mw: 341.43. (1) Benzamide, 5-(aminosulfonyl)-N-[(1-ethyl-2-pyrrolidinyl)methyl]-2-metoxy-; (2) N-[(1-Ethyl-2-pyrrolidinyl)-methyl]-5-sulfamoyl-o-anisamide. CAS-15676-16-1 (1968).

Pharmacologic Category

Antipsychotics, Miscellaneous; Benzamides. (ATC-Code: N05AL01).

Mechanism of action

A substituted benzamide derivative with antipsychotic and antidepressant activity. A selective antagonist at postsynaptic D~2~-receptors. This action dominates in doses exceeding 600 mg daily. In doses of 600 to 1600 mg, sulpiride shows mild sedating and antipsychotic activity. In low doses (in particular 50 to 200 mg daily) its prominent feature is a reuptake inhibition of dopamine accounting for some antidepressant activity and a stimulating effect. Sulpiride appears to lack effects on norepinephrine, acetylcholine, serotonin, histamine, or GABA receptors. Sulpiride also stimulates secretion of prolactin and has been investigated in treatment of inadequate lactation and to improve progestin-only contraception. As sulpiride has been shown to improve blood flow and mucus secretion in gastroduodenal mucosa, its use in duodenal ulcer has also been evaluated. Reportedly has antiemetic actions. Has also been used for treatment of vertigo and migraine headache. Its antipsychotic potency compared to chlorpromazine is only 0.2 (1/5).

Therapeutic use

Schizophrenia. Depression. Vertigo.

Pregnancy and lactiation implications

Animal studies did not reveal any embryo- or fetotoxic properties. Adequate studies in humans not developed. Use in pregnant women only if strictly indicated. Newborns of treated women should be monitored, as isolated cases of extrapyramidal side-effects reported. Sulpiride found in milk of lactating women (not recommended in nursing women).

Unlabeled use

Huntington’s disease. Duodenal ulcer. Poor lactation. Contraception. Tardive dyskinesia.

Contraindications

Hypersensitivity to sulpiride. Pre-existing breast cancer or other prolactin-dependent tumors. Pheochromocytoma. Intoxication with other centrally active drugs. Concomitant use of levodopa.

Warnings and precautions

Despite its relative selectivity for dopamine D~2~ receptors, adverse effects of sulpiride have not differed significantly from those of other neuroleptic agents in most studies; predominant adverse effects have been extrapyramidal reactions and sedation. Tardive dyskinesia reported. Similar to other neuroleptics, sulpiride associated with neuroleptic malignant syndrome and cholestatic jaundice. In manic or hypomanic patients may exacerbate symptoms. In elderly patients there exists increased risk of adverse effects (reduced renal function may be present).

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