Methotrimeprazine (Maleate)

Methotrimeprazine (Maleate) is antipsychotic with actions, uses and adverse effects similar to Chlorpromazine.it also possess some analgesic and sedating properties perticularly useful in terminal care. Chemically Methotrimeprazine (Maleate) is 2-methoxy-N, N, β-trimethyl-10H-phenothiazine-10-propanamine. Methotrimeprazine (Maleate) is available in both oral and parentral forms. Methotrimeprazine (Maleate) is also used to treat schizophrenia and agitated depression.

Brands
Adult Dose
Dose: 0.178 to 0.357 mg/kg
Single Dose: 0.27 (0.2675)
Frequency: 6 hourly
Route: IM
Instructions: -
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose: 12.5 to 0 mg
Single Dose: 6.2 (6.25)
Frequency: As recommended.
Route: Individed doses.
Instructions:
Characteristics
Methotrimeprazine (Maleate) also known as Levomepromazine[Maleate]. . It is of Synthetic origin and belongs to Phenothiazine. It belongs to D2 antagonist pharmacological group on the basis of mechanism of action and also classified in Analgesics and Anti-inflammatory Agents and Antipsychotic Agent pharmacological group.The Molecular Weight of Methotrimeprazine (Maleate) is 444.50. It is weakly acidic drug, 3.47% solution of the drug is isotonic and Its pKa is 9.15.
Contraindications
Methotrimeprazine (Maleate) is contraindicated in conditions like Bone marrow depression,Coma,Heart disease,Close-angle glaucoma.
Effects
The severe or irreversible adverse effects of Methotrimeprazine (Maleate), which give rise to further complications include Tardive dyskinesia, Paralytic ileus, Seizures, Intrahepatic cholestasis, Lens opacities, Maculopathy, Respiratory distress.Methotrimeprazine (Maleate) produces potentially life-threatening effects which include Agranulocytosis, Neuroleptic Malignant Syndrome. which are responsible for the discontinuation of Methotrimeprazine (Maleate) therapy.The signs and symptoms that are produced after the acute overdosage of Methotrimeprazine (Maleate) include Hypotension, Tachycardia, ECG alterations, Drowsiness, Hypothermia, Ventricular arrhythmias, Severe extrapyramidal dyskinesias, Loss of conciousness.The symptomatic adverse reactions produced by Methotrimeprazine (Maleate) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dry mouth, Sedation, Photosensitivity, Parkinsonism, Hypotension, Weight gain, Asthenia, Contact dermatitis, Erythematous rash, Head stroke.
Indications
Methotrimeprazine (Maleate) is primarily indicated in conditions like Anxiety, Moderate to severe pain, Psychosis, Schizophrenia.
Interactions
Methotrimeprazine (Maleate) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineAlcoholBuspirone (HCl)Cimetidine (HCl)Citalopram (HBr)CocainedeferoxamineDisulfiramDronabinolIt may Increase the levels/effect of alcohol.PiperazineVORICONAZOLEdditive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Estimation Tests of serum and urinary Cortisol
Risks
Drug should not be given to Pregnant Mothers, Cardiac / Hypertensive Patients, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
IV Inj, IV Inf, IM Inj, SC Inf Store at room temperature, Between 15°C-30°C. Protect from Sunlight.
Warnings
Methotrimeprazine should be used in low initial dose. Monitor pulse and blood pressure until dosage requirements and responses are stabilized in elderly and debilitated patients.
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