Levosulpiride serves as a powerful medication that helps with both mental health conditions and digestive problems. The drug works by blocking dopamine D2 receptors and stimulating serotonin 5-HT4 receptors. Patients can benefit from levosulpiride tablets when dealing with acute and chronic schizophrenia, functional dyspepsia, burning mouth syndrome, and acute vestibular disorders. This article helps you learn about levosulpiride's effects on your body, its side effects and proper dosage guidelines.

How Does Levosulpiride Work?

This benzamide medication is an atypical antipsychotic with properties that make it work for conditions of all types. The drug works through two main mechanisms:

• Selective antagonist of dopamine D2 receptors that sit on presynaptic membranes in dopaminergic pathways

• Serotonin 5HT4 receptor agonist 

These combined actions make it both a prokinetic and an antipsychotic medication that works well.

The drug blocks enteric D2 dopaminergic receptors in the digestive system and increases acetylcholine release. This improves gastric and intestinal movement, stops acid reflux and helps digestion. The blockade of central dopamine receptors helps control symptoms of psychosis and depression.

Uses of Levosulpiride

Levosulpiride treats many conditions in two main categories:

• Gastrointestinal disorders:

• Functional dyspepsia

• Gastroesophageal reflux disease (GERD)

• Irritable bowel syndrome (IBS)

• Nausea and vomiting

• Gastroparesis

• Psychiatric conditions:

• Schizophrenia

• Depression

• Anxiety disorders

• Vertigo

• Doctors also prescribe it to treat premature ejaculation.

How & When to Take Levosulpiride?

• Adults with gastrointestinal issues usually take 30 minutes before food. 

• Patients should swallow the medicine whole with water. Avoid crushing or chewing it.

• Patients should take it at the same time each day to maintain steady blood levels.

What are the Side Effects of Levosulpiride?

Common side effects include:

• Drowsiness and fatigue

• Constipation or diarrhoea

• Headaches

• Weight gain

• Elevated prolactin levels

Serious reactions might include:

• Extrapyramidal symptoms (tremors, muscle stiffness)

• Akathisia (inability to stay still)

• Increased liver enzymes

• Neuroleptic malignant syndrome in rare cases

Can I Take Levosulpiride Daily?

Doctors can prescribe levosulpiride for daily use. Treatment usually lasts 4-8 weeks depending on the condition. Long-term use needs careful monitoring for side effects, especially hormonal changes like high prolactin levels. Regular doctor visits remain crucial during long-term treatment.

What Precautions are to Be Taken While Using Levosulpiride?

• You should tell your doctor about any health conditions you have. This is particularly important if you have epilepsy, bipolar disorder, or breast cancer, as levosulpiride isn't suitable for these conditions. 

• Patients with kidney failure need their doses adjusted based on creatinine clearance rates. 

• This medication might make you drowsy, so avoid driving or operating machinery.

• More attention is needed if you have heart disease because this medication can affect your heart rate.

• You need extra caution if you:

• Are pregnant or breastfeeding

• Have liver disease

• Are elderly

• Have asthma or a history of neuroleptic malignant syndrome

What If I Missed a Dose?

Take the medicine right away if you remember missing a dose. However, skip the missed dose if it is almost time for your next one and stick to your regular schedule. Don't take a double dose to make up for a missed one.

What If I Overdose?

Medical help becomes necessary immediately after a levosulpiride overdose. Watch out for extreme sleepiness, confusion, irregular heartbeat, and seizures.

Drug Interactions

Levosulpiride can interact with many medicines. Be especially careful with:

• Antiarrhythmic agents (quinidine)

• Antidepressants (haloperidol, lithium)

• Antihypertensive drugs (propranolol, atenolol)

• Diuretics 

You should take levosulpiride at least 2 hours after antacids containing aluminium-magnesium hydroxide to maintain proper absorption. Alcohol should be avoided as it increases the risk of side effects.

Dosage for Levosulpiride

Adults typically need 25-100 mg, two to three times daily. 

The recommended dose if you have functional dyspepsia is 75 mg daily split into three doses. 

Sustained-release tablets of 75 mg once daily are also accessible to more people. 

Lower doses are common for elderly patients and those with kidney problems.

Safety data isn't sufficient for children under 14 years, so they shouldn't take levosulpiride.

Levosulpiride vs Itopride 

Levosulpiride and itopride are prokinetic medications that treat digestive disorders effectively, with notable differences in their properties.

Characteristic	Levosulpiride	Itopride
Chemical Class	Benzamide derivative	Veratamide hydrochloride derivative
Mechanism	D2 receptor antagonist + 5HT4 agonist	D2 receptor antagonist + anticholinesterase activity
Standard Dosage	25 mg three times daily	50 mg three times daily before meals
Symptom Improvement	53% of patients showed improvement	41% of patients showed improvement
Side Effects	Lower incidence	Higher incidence
Common Side Effects	Abdominal pain, nausea, constipation, diarrhoea	Abdominal pain, nausea, dizziness, constipation
CNS Effects	May cause extrapyramidal symptoms	Minimal CNS effects as it doesn't cross the blood-brain barrier
Cardiac Safety	QT prolongation reported in some cases	No cardiac side effects like QT prolongation

Both medications speed up gastric emptying and help patients with functional dyspepsia. Studies demonstrate levosulpiride's superior performance in symptom relief with fewer side effects. Clinical trials showed that both medications avoided serious cardiac toxicity and extrapyramidal symptoms.

FAQs

1. What is Levosulpiride used for?

   Levosulpiride treats digestive and mental health conditions. The medicine helps manage:

   • Gastroesophageal reflux disease

   • Irritable bowel syndrome

   • Functional dyspepsia

   • Psychiatric conditions like depression, anxiety, vertigo, and schizophrenia.

2. How does Levosulpiride work in the body?

   The medicine works through two different ways. It blocks dopamine D2 receptors as a selective antagonist on presynaptic membranes. The drug also acts as a serotonin 5HT4 receptor agonist, which boosts stomach contractions and helps move food better.

3. What is the usual dosage of Levosulpiride for adults and children?

   Adults typically take 25-50mg three times each day. The medication isn't safe for children under 14 because we lack enough safety data. People with functional dyspepsia need 75mg daily split into three doses.

4. Can Levosulpiride be used for digestive issues like GERD and nausea?

   Yes! The medicine speeds up gastric emptying when taken as 25mg three times daily. 

5. What are the common side effects of Levosulpiride?

   Common side effects are: 

   • Headaches

   • Fatigue

   • Drowsiness

   • Changes in weight

   • Women could notice changes in their menstrual cycles.

6. Is Levosulpiride safe for long-term use?

   Doctors usually prescribe it for 4-8 weeks. Longer treatment needs regular monitoring, especially for hormonal changes.

7. Can Levosulpiride interact with other medicines?

   Your doctor needs to know about all medicines you take because levosulpiride can interact with several medicines:

   • Blood pressure medications 

   • Antidepressants 

   • CNS depressants 

   • Levodopa

   • Sucralfate and antacids require you to take levosulpiride at least 2 hours after them

8. Is Levosulpiride safe during pregnancy or breastfeeding?

   Doctors only recommend levosulpiride during pregnancy if the benefits outweigh potential risks. Doctors advise against breastfeeding while taking levosulpiride because it passes into breast milk.

9. What precautions should be taken while using Levosulpiride?

   You need extra caution if you have:

   • Epilepsy or seizure disorders

   • Bipolar disorder

   • Breast cancer history

   • Kidney or liver disease

   • History of heart problems

   Older patients need closer monitoring due to higher risks of drowsiness and blood pressure drops.

10. What should I do if I miss a dose of Levosulpiride?

    Take your missed dose as soon as you remember it. Skip the missed dose if it's nearly time for your next one - never take a double dose. Doctors give levosulpiride injections, so you likely won't miss those doses.