# Levomepromazine

Source: https://onco.cc/drugs/levomepromazine/  
OnCo record `levomepromazine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Levomepromazine is a strong anti-sickness and calming medicine used in hospices and palliative care, often by a small pump under the skin, for nausea, restlessness and distress near the end of life.

## Summary

The UK SmPC for the injection gives "management of the terminally ill patient" and "the management of pain and accompanying restlessness or distress in the terminally ill patient"; the tablets add psychiatric uses. MASCC/ESMO 2016 lists it as an alternative to metoclopramide for nausea and vomiting in advanced cancer. In the EAPC 2024 framework for palliative sedation it is the step 2 medicine, added to midazolam when midazolam alone is not enough. It is not marketed in the US.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Also known as: methotrimeprazine
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: Nozinan
- Modality: Phenothiazine antipsychotic, used as an antiemetic and sedative
- Mechanism: Resembles chlorpromazine and promethazine: anti-emetic, antihistamine and anti-adrenaline activity with a strong sedative effect (UK SmPC 5.1).
- Approvals: UK 2012: Injection: management of pain and accompanying restlessness or distress in the terminally ill patient

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Levomepromazine
- UK SmPC (emc): levomepromazine 25 mg/ml injection: https://www.medicines.org.uk/emc/product/3014/smpc
- UK SmPC (emc): levomepromazine 25 mg tablets: https://www.medicines.org.uk/emc/product/11912/smpc
- Walsh et al., 2016 updated MASCC/ESMO consensus recommendations: management of nausea and vomiting in advanced cancer (Support Care Cancer 2017): https://doi.org/10.1007/s00520-016-3371-3
- Surges et al., Revised EAPC recommended framework on palliative sedation (Palliat Med 2024), table of medications: https://doi.org/10.1177/02692163231220225

## Connected records

- drugs: [Haloperidol](https://onco.cc/drugs/haloperidol/), [Metoclopramide](https://onco.cc/drugs/metoclopramide/), [Midazolam](https://onco.cc/drugs/midazolam/), [Propofol](https://onco.cc/drugs/propofol/)
- technologies: [Antiemetics for chemotherapy-induced nausea and vomiting](https://onco.cc/technologies/antiemetic-therapy/), [Early integrated palliative care](https://onco.cc/technologies/palliative-care/)
- terms: [Palliative sedation](https://onco.cc/terms/palliative-sedation/)

---
JSON: https://onco.cc/api/v1/entities/levomepromazine.json