Sulmetic IV

Introduction
Sulmetic IV is a prescription medicine used in the treatment of schizophrenia, a mental disorder that can result in hallucinations or delusions and also adversely affects a person’s ability to think and behave. Sulmetic IV may be taken with or without food, preferably before bedtime. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms. Some common side effects of this medicine include nausea, vomiting, and dryness in the mouth. Initially, this medicine may cause a sudden drop in blood pressure when you change positions, so it is better to rise slowly if you have been sitting or lying down. It also causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. This medicine can lead to weight gain and may increase your blood sugar and cholesterol levels. However, modifying your lifestyle by having a healthy diet and exercising regularly can reduce this side effect.

_
Uses of Sulmetic IV
Schizophrenia
Side effects of Sulmetic IV
Common
Nausea
Vomiting
Dryness in mouth
Constipation
Weight gain
Decreased blood pressure
Dystonia (involuntary muscle contractions)
Akathisia (inability to stay still)
Parkinsonism
Increased prolactin level in blood
How to use Sulmetic IV
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Sulmetic IV may be taken with or without food, but it is better to take it at a fixed time.
How Sulmetic IV works
Sulmetic IV is an atypical antipsychotic. It works by modulating the action of certain chemical messengers in the brain that affect thoughts.
Quick Tips
Sulmetic IV helps treat schizophrenia.
Take it at bedtime to avoid feeling sleepy during the day.
Use caution while driving or doing anything that requires concentration as Sulmetic IV can cause dizziness and sleepiness.
To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down.
Do not consume alcohol while on treatment with this medicine as it may worsen the side effects.
It may cause increased weight, blood sugar, cholesterol, and triglycerides (fat) levels. Eat healthy and exercise regularly.
Inform your doctor if you are pregnant, planning to conceive or breastfeeding.
Do not stop taking Sulmetic IV without talking to your doctor first as it may cause worsening of symptoms.
Brief Description
Indication
Acute and chronic schizophrenic disorders, in which positive symptoms (such as delusions, hallucinations, thought disorders) and/or negative symptoms (such as blunted affect, emotional and social withdrawal) are prominent, including patients characterised by predominant negative symptoms.
Adult Dose
Adult Acute episodes, 400—800mg daily in two divided doses. Adjust according to response; max 1.2g daily. Mixed positive and negative symptoms, adjust dose to control positive symptoms. Predominant negative symptoms, 50—300mg once daily. Elderly: Dose reduction may be required. Hepatic Failure: Since the drug is weakly metabolised a dosage reduction should not be necessary.

_
Child Dose
Under 18 years, not recommended.
Renal Dose
Amisulpride is eliminated by the renal route. In renal insufficiency, the dose should be reduced to half in patients with creatinine clearance (CRCL) between 30-60 ml/min and to a third in patients with CRCL between 10-30 ml/min. As there is no experience in patients with severe renal impairment (CRCL < 10 ml/min) particular care is recommended in these patients _ Contraindication Prolactin-dependent tumours, phaeochromocytoma. Lactation. Mode of Action Amisulpride binds selectively with a high affinity to human dopaminergic D2/D3 receptor subtypes whereas it is devoid of affinity for D1, D4 and D5 receptor subtypes. Precaution Cardiovascular disease, family history of QT prolongation, hypokalaemia, renal impairment (CrCl <60ml/min), epilepsy, Parkinson's disease, diabetes, risk factors for stroke or VTE, history or family history of breast cancer. Elderly. Withdraw gradually. Pregnancy; ensure contraception in women. Lactation It is not known whether amisulpride is excreted in breast milk, breast-feeding is therefore contra-indicated. _ Side Effect Nervous system disorders: Very common: Extrapyramidal symptoms may occur: tremor, rigidity, hypokinesia, hypersalivation, akathisia, dyskinesia. These symptoms are generally mild at optimal dosages and partially reversible without discontinuation of amisulpride upon administration of antiparkinsonian medication. The incidence of extrapyramidal symptoms which is dose related, remains very low in the treatment of patients with predominantly negative symptoms with doses of 50-300 mg/day. Common: Acute dystonia (spasm torticollis, oculogyric crisis, trismus) may appear. This is reversible without discontinuation of amisulpride upon treatment with an antiparkinsonian agent. Somnolence. Uncommon: Tardive dyskinesia characterized by rhythmic, involuntary movements primarily of the tongue and/or face have been reported, usually after long term administration. Antiparkinsonian medication is ineffective or may induce aggravation of the symptoms. Seizures. Psychiatric disorders: Common: Insomnia, anxiety, agitation, orgasmic dysfunction Gastrointestinal disorders: Common: Constipation, nausea, vomiting, dry mouth Endocrine disorders: Common: Amisulpride causes an increase in plasma prolactin levels which is reversible after drug discontinuation. This may result in galactorrhoea, amenorrhoea, gynaecomastia, breast pain, and erectile dysfunction. Metabolism and nutrition disorders: Uncommon: Hyperglycaemia . Cardiovascular disorders: Common: Hypotension Uncommon: Bradycardia Investigations: Common: Weight gain Uncommon: Elevations of hepatic enzymes, mainly transaminases Immune system disorders: Uncommon: Allergic reaction _ Interaction Other antipsychotics, drugs that prolong QT interval, levodopa, CNS depressants, alcohol, antihypertensives.