sulpiride

CLINICAL USE

Antipsychotic:Acute and chronic schizophrenia

DOSE IN NORMAL RENAL FUNCTION

400–800 mg daily increasing to maximum 2.4 g daily

PHARMACOKINETICS

Molecular weight :341.4

%Protein binding :40

%Excreted unchanged in urine : 90–95

Volume of distribution (L/kg) :1.2–1.7

half-life – normal/ESRD (hrs) :8–9/26

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Give 66% of normal dose, or increase dosing interval by factor of 1.5

10 to 20 : Give 50% of normal dose, or incease dosing interval by factor of 2

<10 : Give 30% of normal dose, or increase dosing interval by factor of 3

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Partly dialysed. Dose as in GFR <10 mL/min

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

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anaesthetics: enhanced hypotensive effect

Analgesics: increased risk of convulsions with tramadol; enhanced hypotensive and sedative effects with opioids

Anti-arrhythmics: increased risk of ventricular arrhythmias with anti-arrhythmics that prolong the QT interval, e.g. procainamide, disopyramide and amiodarone – avoid concomitant use with amiodarone

Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin – avoid concomitant use

Antidepressants: increased level of tricyclics; possibly increased risk of ventricular arrhythmias and antimuscarinic side effects

Anti-epileptics: antagonism (convulsive threshold lowered)

Antimalarials: avoid concomitant use with artemether/lumefantrine

Antipsychotics: increased risk of ventricular arrhythmias with pimozide – avoid concomitant use

Antivirals: concentration possibly increased with ritonavirAnxiolytics and hypnotics: increased sedative effects

Beta-blockers: enhanced hypotensive effect; increased risk of ventricular arrhythmias with sotalol

Diuretics: enhanced hypotensive effect

Lithium: increased risk of extrapyramidal side effects and possibly neurotoxicity

Pentamidine: increased risk of ventricular arrhythmias

Sibutramine: increased risk of CNS toxicity – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Sulpiride is almost entirely excreted in the urine as unchanged drug. Administer with caution and decrease the dose in renal impairment.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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