Sulpiride

What it is and how it works

Sulpiride is a selective dopamine D2 and D3 receptor antagonist. At low doses it preferentially blocks presynaptic autoreceptors, which may increase dopaminergic transmission, whereas higher doses block postsynaptic receptors and produce antipsychotic effects.

Indications

Acute and chronic schizophrenia; in some countries also used at low doses for other indications such as vertigo or depressive symptoms.

Dosage and administration (summary)

Taken orally; for schizophrenia usually 200–400 mg twice daily, adjusted to response (up to 1.2 g twice daily for predominantly positive symptoms, maximum 800 mg daily for predominantly negative symptoms); lower doses in the elderly and renal impairment.

Contraindications

Phaeochromocytoma, prolactin-dependent tumours (e.g. prolactinoma, breast cancer), acute porphyria, and concomitant levodopa or dopaminergic antiparkinsonian drugs.

Warnings and precautions

Hyperprolactinaemia (galactorrhoea, amenorrhoea, gynaecomastia), extrapyramidal effects, tardive dyskinesia, QT prolongation and neuroleptic malignant syndrome may occur. Use with caution in cardiovascular disease, epilepsy and renal impairment; elderly patients with dementia have increased mortality and stroke risk with antipsychotics.

Pregnancy

Avoid in pregnancy unless clearly necessary; neonates exposed in the third trimester may show extrapyramidal or withdrawal symptoms.

Storage and supply

Store below 25 °C.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.