A dopamine-blocking medicine used for nausea and indigestion
Levosulpiride
A dopamine-blocking medicine used as an anti-sickness treatment and to ease the symptoms of indigestion.
What is Levosulpiride?
Levosulpiride is a medicine that blocks dopamine signals and is used both to relieve nausea and vomiting and to ease symptoms of dyspepsia (indigestion), by helping the stomach empty and settling sickness. Because it acts on dopamine, it can cause movement-related effects such as restlessness, tremor or stiffness, especially with longer use or in older people, and it can raise a hormone called prolactin, sometimes causing breast tenderness or changes in periods. It can also make you feel drowsy. It is taken by mouth and is generally used for a limited time.
Education and reference only. This is a plain-language guide to Levosulpiride — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Levosulpiride is a medicine that works by blocking dopamine, a chemical messenger in the body. This action makes it useful in two ways: as an antiemetic, meaning it helps control nausea and vomiting, and as a treatment that eases the symptoms of dyspepsia (indigestion) by helping the stomach move food along. It is taken by mouth as a tablet. Because it affects dopamine, which is also involved in controlling movement and in hormone release, it can cause certain side effects, so it is usually used for a limited time and with attention to how the person responds.
How it works
Levosulpiride blocks dopamine receptors. In the part of the brain that triggers vomiting, blocking dopamine helps calm feelings of sickness, which is why it works as an antiemetic. In the gut, the same action helps the stomach contract and empty more normally, easing the fullness and discomfort of indigestion. However, dopamine is also involved in smooth, controlled movement and in keeping the hormone prolactin in check, so blocking it can sometimes lead to movement-related side effects and a rise in prolactin — effects that become more likely with higher use or over longer periods.
Company & origin
Originated / developed by: Various manufacturers.
A medicine used to relieve nausea and vomiting and to ease symptoms of dyspepsia (indigestion) by acting on dopamine signals.
Practical use
How to take Levosulpiride
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, usually before meals when it is being used for indigestion.
- Use it for the limited time your prescriber recommends rather than long term.
- Tell your prescriber promptly about any unusual movements, restlessness, tremor or stiffness.
- Take care with driving or operating machinery until you know whether it makes you drowsy.
- Mention any breast tenderness, milk production or change in periods, as these can be linked to the medicine.
Weighing it up
Advantages & disadvantages of Levosulpiride
Advantages
- Helps control nausea and vomiting and eases the symptoms of indigestion.
- Works in two useful ways, both settling sickness and helping the stomach empty.
- Taken by mouth, fitting around meals when used for indigestion.
Disadvantages
- Can cause movement-related (extrapyramidal) effects, especially with longer use or in older people.
- Can raise the hormone prolactin, causing breast tenderness, milk production or changes in periods.
- Can cause drowsiness and is generally only suitable for short-term use.
Practical use
Good to know
The main thing to be aware of with levosulpiride is the group of effects that come from blocking dopamine. It can cause movement-related side effects known as extrapyramidal effects — such as restlessness, tremor, muscle stiffness or unusual movements — which are more likely in older people and with longer use, and should be reported promptly. It can also raise the hormone prolactin, which may cause breast tenderness, milk production or changes in periods. It can make you feel drowsy, so take care with driving until you know how it affects you. Because of these effects it is generally used for a limited time rather than long term, and it treats symptoms rather than curing the underlying problem, so symptoms can return after stopping.
Who should not take it / use with caution
- People who have had a serious allergic reaction to levosulpiride should not take it.
- It is avoided in people with certain hormone-sensitive tumours, such as prolactin-related tumours, or phaeochromocytoma.
- It is used with great care, or avoided, in people with Parkinson's disease or a history of movement disorders, and in epilepsy.
Monitoring
- Watching for movement-related side effects, particularly in older people and with longer use.
- Reviewing for signs of raised prolactin, such as breast tenderness or changes in periods.
- Checking that it is used for a limited time and that symptoms are improving.
Side effects
- Drowsiness or tiredness.
- Movement-related effects such as restlessness, tremor, stiffness or unusual movements.
- A rise in the hormone prolactin, causing breast tenderness, milk production or changes in periods.
- Rarely, a serious reaction with high fever and muscle stiffness that needs urgent medical attention.
Key interactions
- It adds to the sedating effect of alcohol and other medicines that cause drowsiness.
- It can work against medicines for Parkinson's disease, which act on dopamine.
- Tell your prescriber about all your medicines, especially others that affect mood, movement or the heart rhythm.
Available as: Tablets taken by mouth.
Answers
Levosulpiride: frequently asked questions
What is levosulpiride used for?
It is used to relieve nausea and vomiting and to ease the symptoms of dyspepsia (indigestion), by blocking dopamine to settle sickness and help the stomach empty.
Why can it cause movement problems?
It blocks dopamine, which is involved in smooth, controlled movement, so it can cause movement-related effects such as restlessness, tremor or stiffness, especially with longer use or in older people.
Can it affect my hormones or periods?
Yes, it can raise a hormone called prolactin, which may cause breast tenderness, milk production or changes in periods; mention these to your prescriber.
Will it make me drowsy?
It can cause drowsiness, so take care with driving or operating machinery until you know how it affects you.
How long should I take it?
Because of its dopamine-related side effects, it is generally used for a limited time rather than long term, as guided by your prescriber.
The wider class
About Dopamine-antagonist antiemetic and gut-motility medicine
Levosulpiride belongs to the dopamine-antagonist antiemetic and gut-motility medicine class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.