Amisulpride
SOLIAN
“Am I soul bride?”
QT prolongation
prolactin elevation
What it isSubstituted benzamide D2/D3 antagonist used for schizophrenia; at lower doses it preferentially blocks presynaptic D2/D3 autoreceptors.
Why this oneRelatively little antimuscarinic or antihistamine burden and usually less weight gain than many antipsychotics.
What limits itRenally cleared, so dose-reduce with renal impairment. Hyperprolactinemia and QT prolongation are the practical constraints.
FDA-approved for
- postoperative nausea/vomiting (IV) (2020)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Prevention of postoperative nausea and vomiting (PONV) | Adult | 5 mg IV single dose at induction | 5 mg once | 5 mg |
| Treatment of PONV | Adult | 10 mg IV single dose | 10 mg once | 10 mg |
Renal Undefined
Hepatic Undefined
Single-dose administration only.
Instructions
- Infuse IV over 1–2 minutes; dilution not required.
- Protect from light; administer within 12 hours of removing the vial from its carton.
Available strengths
- inj 5 mg/2 mL
- inj 10 mg/4 mL
Cautions
- Dose- and concentration-dependent QT prolongation—avoid in congenital long QT syndrome and with droperidol; ECG monitoring with pre-existing arrhythmias/conduction disorders, electrolyte abnormalities, CHF, or other QT-prolonging drugs (e.g., ondansetron)
Adverse reactions
- Increased blood prolactin
- Chills
- Hypokalemia
- Procedural hypotension
- Abdominal distension
- Infusion site pain (treatment indication)
Pregnancy Insufficient human data; no adverse developmental effects in animal studies.
Lactation Present in human milk (11–20× plasma with chronic oral use); consider pumping and discarding milk for 48 h after a dose.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 5 mg/2 mL | inj | per unit | not offered | |
| 10 mg/4 mL | inj | per unit | not offered |
Generic entry2034 est.
NO BOXED WARNINGS
Principal riskQT prolongation; hyperprolactinemia
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilitySedation, QT prolongation, extrapyramidal symptoms or anticholinergic toxicity vary by receptor target.
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