QuickView for Methotrimeprazine (compound)

Summary
General Info

PubChem

PubChem Compound 165002

Name:	Methotrimeprazine
PubChem Compound ID:	165002
Description:	A phenothiazine with pharmacological activity similar to that of both CHLORPROMAZINE and PROMETHAZINE. It has the histamine-antagonist properties of the antihistamines together with CENTRAL NERVOUS SYSTEM effects resembling those of chlorpromazine. (From Martindale, The Extra Pharmacopoeia, 30th ed, p604)
Molecular formula:	C₁₉H₂₄N₂OS
Molecular weight:	328.473 g/mol
Synonyms:	NCGC00016681-01; 2622-31-3; 10H-Phenothiazine-10-propanamine, 2-methoxy-N,N,beta-trimethyl-, (S)-; CAS-7104-38-3; (S)-2-Methoxy-N,N,beta-trimethyl-10H-phenothiazine-10-propanamine

DrugBank

Identification

Name:	Methotrimeprazine
Name (isomeric):	DB01403
Drug Type:	small molecule
Description:	A phenothiazine with pharmacological activity similar to that of both CHLORPROMAZINE and PROMETHAZINE. It has the histamine-antagonist properties of the antihistamines together with CENTRAL NERVOUS SYSTEM effects resembling those of chlorpromazine. (From Martindale, The Extra Pharmacopoeia, 30th ed, p604)
Synonyms:	Levomepromazine
Brand:	Neurocil, Nosinan, Neozine, Levoprome, Nozinan
Category:	Analgesics, Non-Narcotic, Dopamine Antagonists, Antipsychotic Agents
CAS number:	60-99-1

Pharmacology

Indication:	For the treatment of psychosis, particular those of schizophrenia, and manic phases of bipolar disorder.
Pharmacology:	Methotrimeprazine is a phenothiazine with pharmacological activity similar to that of both chlorpromazine and promethazine. It has the histamine-antagonist properties of the antihistamines together with central nervous system effects resembling those of chlorpromazine. (From Martindale, The Extra Pharmacopoeia, 30th ed, p604)
Mechanism of Action:	Methotrimeprazine's antipsychotic effect is largely due to its antagonism of dopamine receptors in the brain. In addition, its binding to 5HT2 receptors may also play a role.
Absorption:	Methotrimeprazine has an incomplete oral bioavailability, because it undergoes considerable first-pass-metabolism in the liver. Oral bioavailability is approximately 50 to 60%.
Biotransformation:	Hepatic. Methotrimeprazine is metabolized in the liver and degraded to a sulfoxid-, a glucuronid- and a demethyl-moiety.
Half Life:	Approximately 20 hours.
Toxicity:	Symptoms of overdose include convulsions, spastic movements, and coma.
Affected organisms:	Humans and other mammals

Interactions

Food interaction:

Take with food to reduce irritation.

Drug interaction:

Grepafloxacin	Increased risk of cardiotoxicity and arrhythmias
Phenelzine	Possible severe adverse reaction with this combination
Levofloxacin	Increased risk of cardiotoxicity and arrhythmias
Amphetamine	Decreased anorexic effect, may increase psychotic symptoms
Metrizamide	Increased risk of convulsions

Grepafloxacin	Increased risk of cardiotoxicity and arrhythmias
Phenelzine	Possible severe adverse reaction with this combination
Levofloxacin	Increased risk of cardiotoxicity and arrhythmias
Amphetamine	Decreased anorexic effect, may increase psychotic symptoms
Metrizamide	Increased risk of convulsions
Sparfloxacin	Increased risk of cardiotoxicity and arrhythmias
Zopiclone	Additive CNS depressant effects. Reduce zopiclone dose by half upon initiation of methotrimeprazine. Zopiclone dose may be adjusted once methotrimeprazine dose has been established. Monitor for increased CNS depression.
Phentermine	Decreased anorexic effect, may increase psychotic symptoms
Pargyline	Possible severe adverse reaction with this combination
Phenylpropanolamine	Decreased anorexic effect, may increase psychotic symptoms
Tranylcypromine	Possible severe adverse reaction with this combination
Bromocriptine	The phenothiazine decreases the effect of bromocriptine
Isocarboxazid	Possible severe adverse reaction with this combination
Lumefantrine	Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Donepezil	Possible antagonism of action
Bromazepam	Concomitant therapy may result in additive CNS depressant effects. The dosage of bromazepam should be decreased by 50% prior to initiating concomitant therapy. Monitor for increased CNS depression.
Zolpidem	Additive CNS depressant effects. Reduce zolpidem dose by half upon initiation of methotrimeprazine. Zolpidem dose may be adjusted once methotrimeprazine dose has been established. Monitor for increased CNS depression.
Tramadol	Additive CNS depressant effects. Decrease dose of tramadol by 50% if initiating methotrimeprazine therapy. Monitor for increased CNS depression and apply further dosage adjustments as required.
Ziprasidone	Additive QTc-prolongation may occur increasing the risk of life-threatening ventricular arrhythmias and torsade de pointes. Concomitant therapy should be avoided.
Dextroamphetamine	Decreased anorexic effect, may increase psychotic symptoms
Zonisamide	Additive CNS depressant effects. Reduce zonisamide dose by half upon initiation of methotrimeprazine. Zonisamide dose may be adjusted once methotrimeprazine dose has been established. Monitor for increased CNS depression.
Methamphetamine	Decreased anorexic effect, may increase psychotic symptoms
Mazindol	Decreased anorexic effect, may increase psychotic symptoms
Benzphetamine	Antipsychotics may diminish the stimulatory effect of Amphetamines. Monitor effectiveness of amphetamine therapy when altering concurrent antipsychotic therapy as antipsychotic agents may impair the stimulatory effect of amphetamines.
Vorinostat	Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Terfenadine	Increased risk of cardiotoxicity and arrhythmias
Paliperidone	The CNS depressant agents, paliperidone and methotrimeprazine, may cause additive CNS depressant effects. Monitor for increased CNS depressant effects during concomitant therapy.
Phendimetrazine	Decreased anorexic effect, may increase psychotic symptoms
Brimonidine	Brimonidine may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of brimonidine. Consider therapy modification.
Guanethidine	Methotrimeprazine may decrease the effect of guanethidine.
Galantamine	Possible antagonism of action
Artemether	Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Fenfluramine	Decreased anorexic effect, may increase psychotic symptoms
Gatifloxacin	Increased risk of cardiotoxicity and arrhythmias
Zaleplon	Additive CNS depressant effects may occur. A dose reduction of zaleplon may be required. Monitor for increased CNS depression during concomitant therapy.
Vigabatrin	Additive CNS depression may occur. Dose adjustments may be required if one agent is added to existing therapy with the other agent. Monitor for increased CNS depression during concomitant therapy.
Phenmetrazine	Decreased anorexic effect, may increase psychotic symptoms
Ziconotide	Additive CNS depressant effects may occur. A dose reduction of ziconotide may be required. Monitor for increased CNS depression during concomitant therapy.
Rivastigmine	Possible antagonism of action
Zuclopenthixol	Additive QTc prolongation may occur. Consider alternate therapy or use caution and monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP). Methotrimeprazine, a strong CYP2D6 inhibitor, may increase the serum concentration of zuclopenthixol by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zuclopenthixol if methotrimeprazine is initiated, discontinued or dose changed.
Cisapride	Increased risk of cardiotoxicity and arrhythmias
Carisoprodol	Carisoprodol, a CNS depressant, may enhance the CNS depressant effect of methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants like carisoprodol. Reduce the dosage of CNS depressants by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage adjustments should be initiated only after clinically effective methotrimeprazine dose has been established. Monitor for increased CNS depression with concomitant therapy.
Diethylpropion	Decreased anorexic effect, may increase psychotic symptoms
Voriconazole	Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Dexfenfluramine	Decreased anorexic effect, may increase psychotic symptoms
Dantrolene	Concomitant therapy may result in additive CNS depressant effects. The dosage of dantrolene should be decreased by 50% prior to initiating concomitant therapy. Monitor for increased CNS depression.