What is it used for?
How does it work?
Sulpitil tablets contain the active ingredient sulpiride, which is a type of medicine called an antipsychotic. It is used to treat the psychiatric illness schizophrenia. (NB. Sulpiride is also available without a brand name, ie as the generic medicine.)
Sulpiride works by blocking dopamine receptors in the brain. Dopamine is a natural compound called a neurotransmitter. These are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. Dopamine is a neurotransmitter known to be involved in regulating mood and behaviour, amongst other things.
Psychotic illness is considered to be caused by disturbances in the activity of neurotransmitters (mainly dopamine) in the brain. Schizophrenia is known to be associated with an overactivity of dopamine in the brain, and this may be associated with the delusions and hallucinations that are a feature of this disease.
Sulpiride works by blocking the receptors in the brain that dopamine acts on. This prevents the excessive activity of dopamine and helps to control schizophrenia.
Schizophrenic patients may experience 'positive symptoms' (such as hallucinations, disturbances of thought, hostility) and/or 'negative symptoms' (such as lack of emotion and social isolation). Sulpiride is effective in relieving both positive and negative symptoms of schizophrenia.
- This medication may cause drowsiness. If affected do not drive or operate machinery. You should avoid drinking alcohol while you are taking this medicine.
- Unless your doctor tells you otherwise, you should not suddenly stop taking this medicine, even if you feel better and think you don't need it any more. This is because the medicine controls the symptoms of the illness but doesn't actually cure it. This means that if you suddenly stop treatment your symptoms could come back. Stopping the medicine suddenly may also rarely cause withdrawal symptoms such as nausea, vomiting, difficulty sleeping or tremor. When treatment with this medicine is stopped, it should be done gradually, following the instructions given by your doctor.
- Consult your doctor immediately if you experience any abnormal movements, particularly of the face, lips, jaw and tongue, while taking this medicine. These symptoms may be indicative of a rare side effect known as tardive dyskinesia, and your doctor may ask you to stop taking this medicine, or decrease your dose.
- Consult your doctor immediately if you experience the following symptoms while taking this medicine: high fever, sweating, muscle stiffness, faster breathing and drowsiness or sleepiness. These symptoms may be due to a rare side effect known as the neuroleptic malignant syndrome, and your treatment may need to be stopped.
Use with caution in
- Elderly people
- Decreased kidney function
- Excited, agitated or aggressive states (hypomania)
- History of epilepsy
- Parkinson's disease
- Disease affecting the heart and blood vessels (cardiovascular disease)
- Personal or family history of an abnormal heart beat, seen on a heart monitoring trace (ECG) as a 'prolonged QT interval', and people taking other medicines that can could increase the risk of this (see end of factsheet for more details)
- Slow heart rate (bradycardia)
- Low level of potassium in the blood (hypokalaemia).
Not to be used in
- Children under 14 years of age
- Severe liver disease
- Severe kidney disease
- Severe blood disorders
- Hereditary blood disorders called porphyrias
- Tumour of the adrenal gland (phaeochromocytoma)
- Tumour of the pituitary gland in the brain (pituitary prolactinoma)
- Breast cancer
- Alcohol intoxication
- Reduced awareness, slow reactions or drowsiness due to illnesses that reduce activity in the central nervous system.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
- This medicine passes into breast milk. It is not recommended for mothers who are breastfeeding. Seek medical advice from your doctor.
- This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Restlessness and agitation
- Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects)
- Rhythmical involuntary movement of the tongue, face, mouth and jaw, which may sometimes be accompanied by involuntary movements of the arms and legs (tardive dyskinesia)
- Difficulty sleeping (insomnia)
- Weight gain
- High blood prolactin (milk producing hormone) level - sometimes this can lead to symptoms such as breast enlargement, production of milk and stopping of menstrual periods
- Sexual problems
- Liver problems such as jaundice or hepatitis
- Irregular heartbeats (arrhythmias)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Antacids (to treat indigestion or heartburn) and sucralfate can reduce the absorption of sulpiride from the gut. As this could make the sulpiride less effective, you should not take antacids or sucralfate at the same time of day as sulpiride. If you need to take these medicines, you should wait at least two hours after taking your dose of sulpiride.
There may be an increased risk of drowsiness if sulpiride is taken with any of the following:
- tricyclic antidepressants, eg amitriptyline
- strong opioid painkillers, eg morphine, codeine
- benzodiazepines, eg diazepam, temazepam
- sedating antihistamines, eg chlorphenamine, hydroxyzine
- sleeping tablets, eg zopiclone.
This medicine may enhance the blood pressure-lowering effects of certain medicines used to treat high blood pressure (antihypertensives). If you are taking medicines for high blood pressure you should tell your doctor if you feel dizzy or faint after starting treatment with this medicine, as your blood pressure medicines may need adjusting.
There may be an increased risk of abnormal heart rhythms (seen as a 'prolonged QT interval' on an ECG) if sulpiride is taken in combination with any of the following medicines:
- medicines for abnormal heart beats (antiarrhythmics), eg amiodarone, procainamide, disopyramide, sotalol, quinidine
- certain antidepressants, eg amitriptyline, imipramine, maprotiline
- the anthistamines astemizole or terfenadine
- certain antimalarials, eg halofantrine, chloroquine, quinine
- other antipsychotics, eg thioridazine, chlorpromazine, sertindole, haloperidol, pimozide
- intravenous erythromycin or pentamidine
- medicines that can lower blood potassium levels, eg laxatives, corticosteroids, or diuretics such as furosemide
- medicines that can slow down the heart rate, eg beta-blockers, clonidine, diltiazem, verapamil, digoxin.
If sulpiride is used in combination with lithium there may be an increased risk of abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal side effects).
Sulpiride may oppose the effects of dopamine agonists used to treat Parkinson's disease, eg levodopa. Equally, levodopa may oppose the antipsychotic effects of sulpiride. These medicines should not be used together.
Sulpiride may also oppose the effects of ropinorole.
Other medicines containing the same active ingredient
Sulpiride tablets are also available without a brand name, ie as the generic medicine.