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Indications & Uses
Amisulpride is used to treat acute and chronic schizophrenic disorders. It suits people whose illness is marked by positive symptoms, such as delusions, hallucinations and thought disorders, and also those with negative symptoms, such as blunted affect and emotional and social withdrawal. It can be used as well for patients in whom negative symptoms are the main problem.
Pharmacology
Amisulpride belongs to a group of medicines called antipsychotics, which help control the symptoms of a mental illness called schizophrenia. It binds selectively to the human dopaminergic D2 and D3 receptors, and it has no affinity for all, D4 and D5 receptor subtypes. Classical and atypical neuroleptics behave differently here, because amisulpride shows low affinity for serotonin, a-adrenergic and histamine receptor subtypes, as well as muscarinic receptors and sigma sites. It does not induce catalepsy, and repeated treatment does not produce D2 hypersensitivity. It also blocks pre-synaptic D2/D3 dopamine receptors in preference to others, which produces dopamine release, and this is responsible for its disinhibitory effects.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Oral dose: For acute psychotic episodes, Amisulpride is recommended at 400 mg/day to 800 mg/day in individual cases. The daily dose can be raised up to 1200 mg/day. Doses above 800 mg/day have not been shown to work better than lower doses, and they may increase the number of adverse events. You don't need a specific titration when starting Amisulpride. Adjust the dose according to how each patient responds, and give it preferably before a meal.
For patients with mixed positive and negative symptoms, adjust the dose to get the best control of the positive symptoms. Maintenance treatment should be set individually, using the lowest dose that works. For patients whose symptoms are mainly negative, oral doses of 50 mg/day to 300 mg/day are recommended, again adjusted for each person.
Injectable dose: The recommended adult injectable dose and infusion rate for each indication are given below.
Prevention of postoperative nausea and vomiting: 5 mg as a single intravenous injection, infused over 1 to 2 minutes at the time of induction of anesthesia.
Treatment of postoperative nausea and vomiting: 10 mg as a single intravenous injection, infused over 1 to 2 minutes, if nausea and/or vomiting occurs after a surgical procedure.
Side Effects
Common side effects of amisulpride include trembling, muscle stiffness or spasm, slow movement, producing more saliva than usual, and feeling restless. Some patients have movements they cannot control, mainly of the head, neck, jaw or eyes. Others have difficulty sleeping (insomnia), or feel anxious or agitated, drowsy or sleepy. Constipation, feeling or being sick, dry mouth, putting on weight, low blood pressure, dizziness, difficulty reaching orgasm and blurred vision can also happen. Increased blood levels of prolactin are common too. Rare side effects are movements you cannot control, mainly of the face or tongue, and osteoporosis (a condition where your bones are more likely to break) or osteopenia (bone weakening). Aspiration pneumonia is also rare. It is a type of lung infection that occurs when food, saliva, liquids or vomit is breathed into the lungs or the airways leading to the lungs, instead of being swallowed into the esophagus and stomach.
Cautions & Contraindications
Warnings & Precautions
Neuroleptic Malignant Syndrome (NMS) is a potentially fatal condition that has been reported with antipsychotic medicines, and Amisulpride is one of them. It is marked by high body temperature (hyperthermia), muscle rigidity, unstable autonomic function and raised CPK. If any symptoms appear that could suggest NMS, particularly with high daily doses, all antipsychotic medicines including Amisulpride should be stopped. Amisulpride can lower the seizure threshold, so patients with a history of seizures should be watched closely while they are on Amisulpride therapy. Withdrawal symptoms have been described after high therapeutic doses of antipsychotic drugs are stopped abruptly. Involuntary movement disorders (such as akathisia, dystonia and dyskinesia) have also been reported with Amisulpride. For this reason, it is advisable to withdraw Amisulpride gradually. Amisulpride raises plasma prolactin levels. This may lead to galactorrhoea, amenorrhoea, gynaecomastia, breast pain, orgasmic dysfunction and impotence.
Contraindications
Amisulpride must not be used if the person is hypersensitive to the active ingredient or to any other ingredient in the medicine. It is also contraindicated when prolactin-dependent tumours are present, for example pituitary gland prolactinomas and breast cancer. Other contraindications are pheochromocytoma, children up to puberty, pregnancy and lactation. It must not be combined with certain medicines either. These are Class-I anti-arrhythmic agents such as quinidine and disopyramide, and Class-II anti-arrhythmic agents such as amiodarone and sotalol. The list also includes bepridil, cisapride, sultopride, thioridazine, methadone, intravenous erythromycin, intravenous vincamine, halofantrine, pentamidine, sparfloxacin and levodopa. In hepatic impairment, amisulpride may be contraindicated, because the disease can affect how the body handles the medicine and this could raise the risk of adverse events.
Pregnancy & Breastfeeding
Nobody has established that amisulpride is safe during human pregnancy, so it isn't recommended in pregnancy. The same applies to women who could become pregnant and are not using effective contraception. The exception is when the benefits justify the possible risks, and in that case the dose and the length of treatment should be kept as low and as short as possible.
Amisulpride has been found in the breast milk of women who are treated with it. Breast-feeding is contraindicated.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
In elderly patients, amisulpride should be used with particular caution because it may cause low blood pressure or sedation.
Children and adolescents under 18 years of age: the efficacy and safety of amisulpride have not been established in this group. If treatment is absolutely required for an adolescent aged 15 to 18 years, it must be started and carried out by a physician experienced in treating schizophrenia in this age group.
Liver impairment: amisulpride is only weakly metabolized, so a dose reduction should not be necessary.
Patients with kidney problems should be given a lower dose. This may be half or a third of the usual daily dose, depending on how well your kidneys are working.
Renal impairment: amisulpride is eliminated through the kidneys. In renal insufficiency, the dose should be cut to half in patients with creatinine clearance (CRCL) between 30 to 60 mL/min, and to a third in patients with CRCL between 10 to 30 mL/min. There is no experience in patients with severe renal impairment (CRCL<10 mL/min), so particular caution is recommended in these patients.
Overdose
We don't have much experience of Amisulpride taken in overdose. Where cases have been reported, the known effects of Amisulpride were stronger than usual. These can include drowsiness, sedation, low blood pressure (hypotension), extrapyramidal symptoms and coma. Deaths have been reported mostly when Amisulpride was taken together with other psychotropic medicines.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Amisulpride below 30°C, in a cool, dry place and away from light. Keep all the medicine out of the reach of children.
Drug Interactions
Common questions about Sulpride 100 mg
What is Sulpride 100 mg Tablet?
Sulpride 100 mg Tablet is a medicine that contains Amisulpride. It is made by Everest Pharmaceuticals Ltd. It belongs to the Atypical neuroleptic drugs group of medicines.
What is Sulpride used for?
Amisulpride is used to treat acute and chronic schizophrenic disorders. It suits people whose illness is marked by positive symptoms, such as delusions, hallucinations and thought disorders, and also those with negative symptoms, such as blunted affect and emotional and social withdrawal.
What are the side effects of Sulpride?
Common side effects of amisulpride include trembling, muscle stiffness or spasm, slow movement, producing more saliva than usual, and feeling restless. Some patients have movements they cannot control, mainly of the head, neck, jaw or eyes.
Can I take Sulpride during pregnancy or while breastfeeding?
Nobody has established that amisulpride is safe during human pregnancy, so it isn't recommended in pregnancy. The same applies to women who could become pregnant and are not using effective contraception. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Sulpride?
We don't have much experience of Amisulpride taken in overdose. Where cases have been reported, the known effects of Amisulpride were stronger than usual. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Sulpride?
Keep Amisulpride below 30°C, in a cool, dry place and away from light. Keep all the medicine out of the reach of children.
Can I take other medicines with Sulpride?
Some medicines can interact with Amisulpride, for example: Ropinirole, Pregabalin, Bromocriptine, Clozapine, Clonidine Hydrochloride, Diltiazem Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Sulpride is already among the lowest-priced brands of Amisulpride at this strength.
Do I need a prescription for Sulpride?
Sulpride is a prescription (Rx) medicine. Take it as your doctor advises.