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Levomepromazine 6mg oral

Updated 2 Feb 2023 | Antipsychotics


Oral formulations of levomepromazine containing 6mg.

Drugs List

  • levomepromazine 6mg tablets
  • Therapeutic Indications


    Nausea,vomiting in terminal care when other drugs ineffective/unavailable

    Second or third line treatment of adults with refractory nausea unassociated with chemotherapy in palliative care.



    Nausea in palliative care
    Day 1 to 3: 3mg to 6mg once daily at night for 3 days.
    Day 4 to 5: Titrate dose to 6mg twice a day (maximum 12mg daily).
    Day 6 to 14: 12mg once daily at night.

    Patients dose should be reviewed daily. The maximum treatment duration is 2 weeks.

    Other sources suggest an alternative dose for nausea and vomiting in palliative care:
    6mg at bedtime, increased if necessary to 12.5mg to 25mg twice a day.

    Patients with Renal Impairment

    Alternative sources recommend starting with small doses in severe renal impairment due to increased cerebral sensitivity.


    Children under 18 years
    Long QT syndrome
    Torsade de pointes

    Precautions and Warnings

    Family history of long QT syndrome
    Predisposition to diabetes mellitus
    Predisposition to epileptic disorder
    Predisposition to prolongation of QT interval
    Predisposition to venous thromboembolism
    Prolonged starvation
    Risk of cerebrovascular accident
    Cardiovascular disorder
    Diabetes mellitus
    Electrolyte imbalance
    Epileptic disorder
    Glucose-galactose malabsorption syndrome
    Hepatic impairment
    History of long QT syndrome
    History of torsade de pointes
    History of ventricular arrhythmias
    Lactose intolerance
    Second degree atrioventricular block
    Severe renal impairment
    Third degree atrioventricular block

    Correct electrolyte disorders before treatment
    Advise ability to drive/operate machinery may be affected by side effects
    May reduce seizure threshold
    Contains lactose
    Keep patient supine when receiving large initial doses
    Perform ECG before and during treatment
    Diabetic control may need adjustment
    Monitor ECG prior to increasing dosage
    Monitor patients at risk for signs & symptoms of venous thromboembolism
    Monitor serum electrolytes
    May cause postural hypotension especially in elderly
    Predisposition QT prolongation: Counsel patient on symptoms of arrhythmias
    Discontinue if Torsade de Pointes should occur during treatment
    Advise patient to avoid alcohol during treatment
    Male & female: May cause infertility
    Female: Ensure adequate contraception during treatment

    Cases of venous thromboembolism (VTE) have been reported with antipsychotic medication. All possible risk factors for VTE should be identified before and during treatment and preventative measures taken.

    Pregnancy and Lactation


    Levomepromazine is contraindicated during pregnancy.

    The manufacturer does not recommend using levomepromazine during pregnancy or in women of childbearing potential not using contraception. At the time of writing there is no published information regarding the use of levomepromazine during pregnancy. Safety in pregnancy has not been established.

    Levomepromazine may cause dose-dependant withdrawal symptoms or transient extrapyramidal symptoms in neonates. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, or feeding disorder and newborns should be monitored carefully.


    Levomepromazine is contraindicated during breastfeeding.

    The manufacturer advises that the patient either discontinues levomepromazine or discontinues breastfeeding. Available data indicates that levomepromazine is excreted in human breast milk in low amounts. Effects on exposed infants are unknown.

    Side Effects

    Accelerated erythrocyte sedimentation
    Acid/base balance disturbance
    Allergic dermatitis
    Blurred vision
    Cardiac arrest
    Cardiac arrhythmias
    Cholestatic liver changes
    Corneal opacities
    Decreased glucose tolerance
    Deep vein thrombosis (DVT)
    Difficulty in micturition
    Dry mouth
    ECG changes
    Electrolyte disturbances
    Extrapyramidal effects
    Heat stroke
    Hepatocellular damage
    Inappropriate secretion of antidiuretic hormone
    Intestinal colic
    Lens opacities
    Necrotising enterocolitis
    Neuroleptic malignant syndrome
    Paralytic ileus
    Parkinson-like symptoms
    Pigmented retinopathy
    Precipitation of diabetes
    Prolongation of QT interval
    Pulmonary embolism
    Sudden unexplained death
    Tardive dyskinesia
    Torsades de pointes
    Venous thrombosis
    Ventricular arrhythmias
    Ventricular fibrillation
    Ventricular tachycardia


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2021

    Reference Sources

    Summary of Product Characteristics: Levomepromazine Maleate 6mg Tablets. Morningside Healthcare Ltd. Revised April 2020.

    The Renal Drug Handbook. Fifth Edition (2019) ed. Ashley, C. and Dunleavy, A. Radcliffe Publishing Ltd, London.

    NICE Evidence Services Available at: Last accessed: 14 January 2021.

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