II. Indications
-
Postoperative Nausea and Vomiting
- Rescue treatment for those failing Antiemetic prophylaxis
- Acute Psychosis or Schizophrenia
- Used in europe, but not FDA approved for this use in the United States
III. Contraindications
IV. Precautions
- Amisulpride photodegrades and must be used within 12 hours of the vial being removed from its protective carton
V. Mechanism
- Selective Dopamine Receptor Antagonist (D2 and D3), blocking activity at the ChemoreceptorTrigger Zone (CTZ)
VI. Dosing
- Prevention of Postoperative Nausea and Vomiting (PONV)
- Give 5 mg IV over 1-2 minutes at time of Anesthesia induction
- Treatment of Postoperative Nausea and Vomiting (PONV)
VII. Adverse Effects
- Hyperprolactinemia
- Hypokalemia
- Chills
-
QTc Prolongation
- Antiemetic doses have not been associated with QT Prolongation
VIII. Safety
- Unknown safety in pregnancy
- Avoid in Lactation (or discard pumped Breast Milk for 48 hours)
- Amisulpride concentrates in Breast Milk at concentrations up to 20 fold higher than the mother's plasma
IX. Drug Interactions
- See Prolonged QT Interval due to Medication
-
Dopamine Agonists (e.g. Levodopa)
- Combined use decreases effect of both the Dopamine Agonist and Amisulpride
X. Resources
XI. References
- (2020) Med Lett Drugs Ther 62(1614): 205-7
- (2023) Postoperative Nausea and Vomiting Management, Presc Lett, #390431