Amisulpride

CLINICAL USE

Treatment of acute and chronic
schizophrenia

DOSE IN NORMAL RENAL FUNCTION

50–1200 mg daily (in divided doses if
>300 mg); varies according to indication

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
369.5

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
16

%Excreted unchanged in urine &nbsp &nbsp :
50

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
5.8

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
12/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–60 Reduce dose by 50%
10–30 Use a third of the dose.

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :
Use with caution. Start with
minimum dose and increase
according to patient’s response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
Not dialysed. Dose as in
GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
Poorly dialysed. Dose as in
GFR <10 mL/min

HDF/high flux &nbsp :
Unknown dialysability. Dose as in
GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:
Poorly dialysed. Dose as in
GFR=10–30 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Alcohol: may enhance CNS effects of

alcohol

Anaesthetics: enhanced hypotensive effect

Analgesics: increased risk of convulsions

with tramadol; enhanced hypotensive and
sedative effects with opioids

Antiarrhythmics: increased risk of

ventricular arrhythmias with antiarrhythmics that prolong the QT interval;
avoid concomitant use with amiodarone,
disopyramide and procainamide (risk of
ventricular arrhythmias)

Antibacterials: avoid concomitant use with

parenteral erythromycin (increased risk of
ventricular arrhythmias)

Antidepressants: increased level of

tricyclics

Antiepileptics: antagonises anticonvulsant

effect

Antihypertensives: increased risk of

hypotension

Antimalarials: avoid concomitant use with

artemether/lumefantrine
Antipsychotics: increased risk of

ventricular arrhythmias with sertindole –
avoid concomitant use

Antivirals: concentration possibly

increased by ritonavir
Anxiolytics & hypnotics: increased

sedative effects

Atomoxetine: increased risk of ventricular

arrhythmias

Beta-blockers: increased risk of ventricular

arrhythmias with sotalol
Diuretics: increased risk of ventricular

arrhythmias due to hypokalaemia

Pentamidine: increased risk of ventricular

arrhythmias – avoid

Sibutramine: increased risk of CNS

toxicity – avoid concomitant use

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Elimination half-life is unchanged in

patients with renal insufficiency, while
systemic clearance is reduced by a factor
of 2.5–3. The area under the curve of
amisulpride in mild renal failure is
increased 2-fold, and almost 10-fold in
moderate renal failure. Experience is
limited and there is no data with doses
>50 mg

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