Amisulpride

Amisulpride Brand Name– BARHEMSYS

What is Amisulpride

Amisulpride is a parenteral antiemetic medication that is a dopamine-2 (D2) and dopamine-3 (D3) antagonist.

It is used intravenously for the prevention and treatment of postoperative nausea and vomiting (PONV).

For the prevention of PONV, it may be used either alone or in combination with an antiemetic of a different class.

Two randomized, double-blind, placebo-controlled trials were conducted in adult patients for the prevention of PONV. 

In a trial of patients who received amisulpride 5 mg IV alone at the time of anesthesia induction, amisulpride was significantly more effective than placebo at treating patients (44% amisulpride vs. 33% placebo).

In a PONV prevention trial in patients who received 5 mg of amisulpride IV or placebo in combination with another antiemetic, efficacy was better in the amisulpride treatment group (58% amisulpride vs. 47% placebo).

For the treatment of PONV, amisulpride may be used in patients who have received antiemetic prophylaxis with an agent of a different class or in those who have not received prophylaxis.

Two randomized, double-blind, placebo-controlled trials were conducted in adult patients for the treatment of PONV. During these clinical trials, amisulpride 10 mg IV was significantly more effective than placebo at treating PONV in patients who had failed an antiemetic in a different class (42% amisulpride vs. 29% placebo) and in treating PONV in patients who had received no prior prophylaxis (31% amisulpride vs. 22% placebo).

Amisulpride can cause dose- and concentration-related prolongation of the QT interval, and cardiac monitoring is recommended for certain patients.

Indications

  • post-operative nausea/vomiting (PONV)
  • post-operative nausea/vomiting (PONV) prophylaxis

For the treatment of post-operative nausea/vomiting (PONV) in patients who have or have not received antiemetic prophylaxis with an agent of a different class

Side Effects

  1. agitation
  2. agranulocytosis
  3. angioedema
  4. anxiety
  5. bradycardia
  6. chills
  7. confusion
  8. drowsiness
  9. dyskinesia
  10. dystonic reaction
  11. elevated hepatic enzymes
  12. hyperprolactinemia
  13. hypokalemia
  14. hypotension
  15. injection site reaction
  16. insomnia
  17. neuroleptic malignant syndrome
  18. QT prolongation
  19. seizures
  20. torsade de pointes
  21. tremor
  22. urticaria
  23. ventricular tachycardia

Monitoring Parameters

  • ECG
  • laboratory monitoring not necessary

Contraindications

  • apheresis
  • AV block
  • bradycardia
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • females
  • fever
  • geriatric
  • heart failure
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • infertility
  • long QT syndrome
  • myocardial infarction
  • pheochromocytoma
  • pregnancy
  • QT prolongation
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • sickle cell disease
  • sleep deprivation
  • stroke
  • syncope
  • systemic lupus erythematosus (SLE)

Interactions

No information is available regarding drug interactions associated with Amisulpride

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