{"entity":{"id":"levomepromazine","kind":"drug","name":"Levomepromazine","aka":["methotrimeprazine"],"tldr":"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.","status":"approved","asOf":"2026-11-11","wikipedia":"https://en.wikipedia.org/wiki/Levomepromazine","links":[{"label":"UK SmPC (emc): levomepromazine 25 mg/ml injection","url":"https://www.medicines.org.uk/emc/product/3014/smpc"},{"label":"UK SmPC (emc): levomepromazine 25 mg tablets","url":"https://www.medicines.org.uk/emc/product/11912/smpc"},{"label":"Walsh et al., 2016 updated MASCC/ESMO consensus recommendations: management of nausea and vomiting in advanced cancer (Support Care Cancer 2017)","url":"https://doi.org/10.1007/s00520-016-3371-3"},{"label":"Surges et al., Revised EAPC recommended framework on palliative sedation (Palliat Med 2024), table of medications","url":"https://doi.org/10.1177/02692163231220225"}],"tags":["supportive","generic","supportive-care-gaps-2026-11"],"related":["haloperidol","midazolam","metoclopramide"],"cancers":[],"sections":[],"technologies":["antiemetic-therapy","palliative-care"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["palliative-sedation"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo supportive care gap fill (DailyMed, openFDA, Drugs@FDA, emc SmPCs, NICE, ESMO, ASCO, MASCC, SITC, ASTCT, ITAC, Europe PMC)","editedOn":"2026-11-11"},"brand":"Nozinan","modality":"Phenothiazine antipsychotic, used as an antiemetic and sedative","supportive":true,"mechanism":"Resembles chlorpromazine and promethazine: anti-emetic, antihistamine and anti-adrenaline activity with a strong sedative effect (UK SmPC 5.1).","approvals":[{"region":"UK","year":2012,"indication":"Injection: management of pain and accompanying restlessness or distress in the terminally ill patient","note":"Year is the first authorisation of UK licence PL 29831/0462 as printed in its SmPC, not the first approval of the medicine"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/levomepromazine/","neighbours":{"drug":[{"id":"haloperidol","kind":"drug","name":"Haloperidol","route":"/drugs/haloperidol/"},{"id":"metoclopramide","kind":"drug","name":"Metoclopramide","route":"/drugs/metoclopramide/"},{"id":"midazolam","kind":"drug","name":"Midazolam","route":"/drugs/midazolam/"},{"id":"propofol","kind":"drug","name":"Propofol","route":"/drugs/propofol/"}],"technology":[{"id":"antiemetic-therapy","kind":"technology","name":"Antiemetics for chemotherapy-induced nausea and vomiting","route":"/technologies/antiemetic-therapy/"},{"id":"palliative-care","kind":"technology","name":"Early integrated palliative care","route":"/technologies/palliative-care/"}],"term":[{"id":"palliative-sedation","kind":"term","name":"Palliative sedation","route":"/terms/palliative-sedation/"}]}}