Phenothiazine antipsychotic / antiemetic
Levomepromazine
Brand names: Nozinan
Adult dose
Dose: Antiemetic (palliative): 6.25–25mg PO/SC OD-BD; CSCI 6.25–25mg/24h. Psychiatric: 25mg TDS-QDS PO
Route: PO/SC/IM
Frequency: OD-BD
Clinical pearls
- Broad-spectrum antiemetic in palliative care (D2/H1/5-HT2/muscarinic) — useful when single-receptor agents fail
- Lower antiemetic doses are not as sedating
Contraindications
- CNS depression
- Comatose states
- Concurrent QT-prolonging drugs (relative)
- Phaeochromocytoma
- Severe cardiovascular disease
Side effects
- Sedation (marked)
- Postural hypotension
- Anticholinergic effects
- EPSE
- NMS
- QT prolongation
- Hyperprolactinaemia
Interactions
- QT-prolonging drugs
- CNS depressants
- Levodopa antagonism
- Lithium
Monitoring
- BP
- ECG
- Mental state
Reference: BNF; Palliative care formulary; https://bnf.nice.org.uk/drugs/levomepromazine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF