23rd Nov 2022
M.S. Counseling Psychology
Methotrimeprazine, also known as Levomepromazine, is an antipsychotic medication that is part of the phenothiazine drug class and is primarily used in the treatment of schizophrenia and manic phases of bipolar disorder.  Levomepromazine can increase the risk of severe adverse effects, including heart failure, a fast or irregular pulse, and pneumonia, which can be fatal in older adults with dementia. 
Some brand names for methotrimeprazine include Nozinan®, Nosinan®, Levoprome® , and Neurocil®.  Two common generic names are Levomepromazine hydrochloride and Levomepromazine HCI. 
Methotrimeprazine is primarily used to treat severe mental disorders such as psychosis and schizophrenia and the manic phases of bipolar disorder. It is also commonly used to treat pain, nausea, and vomiting and to ease other symptoms of end-of-life care, like delirium (confused thinking, being unaware of one’s surroundings) and agitation. 
Methotrimeprazine may be used to treat other mental and emotional health disorders, such as:
Methotrimeprazine may be used to treat physical conditions, such as:
Phenothiazine medications, like Levomepromazine, decrease the transmission of dopamine in the brain, which provides a quieting effect  and helps calm brain activity, reducing pain, nausea, and vomiting. Patients experience a detachment from their symptoms, and they are said to be less bothered by them. 
Methotrimeprazine is typically taken orally in tablet or liquid form. It is available as an intramuscular or intravenous injection (normally used in end-of-life care).
It is always important to follow your doctor's directions. Methotrimeprazine should not be crushed or chewed, only swallowed with a glass of water.  You may take it with food, but it is not required.
Your doctor will determine the dosage and form of medication based on age, symptoms, and pre-existing medical conditions. Tablet form doses range from 2 mg to 50 mg. Oral solutions are available in 5 mg/mL, and intramuscular and intravenous solutions are available in 25 mg/mL strength.
Adults with schizophrenia typically start on 1-3 pills per day, divided into three doses. Individuals confined to bed may receive 4-8 tablets daily, divided into three doses. To determine the best dose for you, your doctor may change these doses. In general, children should not take more than 1-½ pills daily. 
Adults and the elderly typically receive ½ to 2 tablets every 4-8 hours for pain, but your doctor may change the dosage to achieve the desired results. Methotrimeprazine is not used to treat pain in children. 
If you miss a dose, take your tablets as soon as you remember. Do not take two doses to make up for a missed dose. If you are unsure, contact your doctor or pharmacist.
Methotrimeprazine remains in the body for 3-5 days on average  and about eight days in the brain.  Most drugs can be detected in urine from 1-3 days after last use  and in blood for about four days.  Most medications can remain in hair cells for around 90 days. 
Medications can provide many benefits to improve symptoms and conditions, but side effects are possible. Drugs can have varying effects on different people, but the advantages often outweigh the risks, so it's important to talk to your health provider about what options might work best for you.
Methotrimeprazine can cause a variety of mild to severe physical and mental side effects.
Common side effects may include: 
Other side effects that are less common may include: 
You may experience one or more of these common symptoms shortly after starting Methothrimeprazine. With time, your body will likely adjust, and the side effects may disappear. If symptoms worsen or continue, talk to your doctor.
Severe side effects are less likely, but may still happen. If you show any signs of allergic reaction such as severe skin itching, red rash or hives (red bumps), swelling of face, lips, tongue, or throat, or you have difficulty breathing, seek emergency help immediately.
A syndrome of inappropriate antidiuretic secretion (SIADH) can occur. You should call your doctor immediately if you or someone taking Methothrimeprazine has the following symptoms: 
You should call your medical provider if you experience severe side effects  such as:
Don't take Methotrimeprazine if you are allergic to it or its ingredients,  if you have a history of constipation, stomach bloating, or pain or if you have had a blocked intestine (paralytic ileus). 
Talking to your doctor about all your medications and health conditions is important. You should speak with your doctor before taking Methotrimeprazine if you have any of the following health conditions: 
Your health provider will order tests before prescribing Nozinan while on it or if you are taking other drugs for your heart, anti-depressants, or other mental health conditions.  These tests include: 
You should tell your doctor if you need to go to the dentist.  Talk to your doctor before starting methotrimeprazine if you could become pregnant and are not using effective birth control, if you are pregnant, or plan to become pregnant. Methotrimeprazine taken during pregnancy can harm the baby and impact fertility. Don't breastfeed while on Methotrimeprazine. 
Methotrimeprazine can make you sleepy, confused, disoriented, lightheaded, and dizzy, so avoid operating machinery or a vehicle while taking it. 
It is important to keep scheduled appointments with your healthcare provider and take your medication as prescribed. Do not stop Methotrimeprazine or start a new medication without talking to your healthcare provider.
Do not take Methotrimeprazine tablets, and tell your health provider or pharmacist if you are taking any of the following medications: 
Keep a list that includes all prescription, non-prescription, supplement, and herbal products, and share it with your doctor.
Before you start taking Methotrimeprazine, tell your health provider or pharmacist if you are taking any of the following: 
Do not drink alcohol while you are taking Methotrimeprazine. Avoid drinking black tea or coffee since they reduce Methotrimeprazine absorption. 
Methotrimeprazine should be stored in its original container, in a cool dark place, and away from high humidity. It should be stored at temperatures under 25º C (77º F) and away from light. 
Keep Methotrimeprazine out of reach of children and in a secure location. Do not share or give prescription medication to anyone else. It is illegal to share or sell prescription drugs with others. Failing to keep medications away from children or others can cause severe medical problems and may be fatal.
Do not flush unused medication or throw it away in the trash. Check with your local pharmacy or health provider's office about methods to safely dispose of unused prescriptions or for information on drug-takeback programs.
A deliberate or accidental overdose of Methotrimeprazine is dangerous and can be fatal. If you or a child accidentally swallow too many tablets, call your doctor or the nearest hospital emergency department immediately.
It is important to seek medical attention immediately if someone shows any signs of overdose , such as:
You should immediately contact your healthcare provider or the poison control center for additional treatment information if a drug overdose is suspected. The number for the poison control center is 1-800-222-1222.
If someone has collapsed, is unconscious, has a seizure, or has problems breathing, immediately call 911 for emergency services. Delaying treatment of severe symptoms can cause long-term damage or even death.