Prescription Required 
Formulation : 
Description
Indications
Methotrimeprazine is employed in the treatment of severe mental and mood disorders, including schizophrenia and bipolar disorder. This medication exerts calming, relaxing, and pain-relieving effects. Its mechanism of action involves aiding in the restoration of specific natural substances in the brain. As a member of the phenothiazines class, methotrimeprazine facilitates clearer thinking and active participation in daily life.
Uses and Dosage
Administer this medication orally with food as directed by your doctor. To minimize the risk of side effects, such as drowsiness, your doctor may advise starting at a low dose and gradually increasing it. The dose will be adjusted to determine the most effective amount for you. Initially, your doctor may instruct you to divide the dose, taking the medication 2 to 3 times daily. As you continue with the treatment, your doctor might shift to a once-daily dosage, typically before bedtime. Adhere to your doctor’s instructions diligently.
The prescribed dosage is contingent on your medical condition, age, and response to the treatment. For children, the dosage is also determined by weight. If drowsiness proves to be problematic, your doctor may recommend a lower dose during the day and a higher dose at bedtime.
When using the liquid form of this medication, measure the dose precisely with a specialized measuring device or spoon. Avoid using a household spoon, as it may result in an incorrect dose.
Consistently take this medication to derive the maximum benefit. To aid in remembering, take it at the same time(s) each day. Do not discontinue the medication without consulting your doctor, as abrupt cessation may worsen certain conditions.
Gradual dose reduction may be necessary.
Inform your doctor if your condition does not improve or if it worsens.
Side Effects
Some side effects may occur that usually do not need medical attention:
- constipation (mild)
- decreased sweating
- dizziness
- drowsiness
- dryness of mouth
- nasal congestion
- changes in menstrual period
- decreased sexual ability
- increased sensitivity of eyes to light
Inform your healthcare provider immediately if you experience any serious side effects:
- blurred vision, change in color vision, or difficulty in seeing at night
- fainting
- loss of balance control
- mask-like face
- restlessness or need to keep moving
- shuffling walk
- stiffness of arms or legs
- trembling and shaking of hands and fingers
- difficulty in urinating
- skin rash
- inability to move eyes
- increased blinking or spasms of eyelid
- lip smacking or puckering
- muscle spasms of face, neck, body, arms, or legs causing unusual postures or unusual expressions on face
- puffing of cheeks
- rapid or worm-like movements of tongue
- sticking out of tongue
- tic-like or twitching movements
Caution
- Before taking methotrimeprazine, inform your doctor or pharmacist if you have any allergies, particularly to methotrimeprazine, other phenothiazines (such as chlorpromazine), or any other substances in the product. Inactive ingredients may be present, leading to allergic reactions or other issues.
- Provide your medical history to your doctor or pharmacist, especially if you have blood problems, brain injury/tumor, severe nervous system problems, liver disease, adrenal gland issues (pheochromocytoma), glaucoma, heart problems, Parkinson’s disease, seizures, or difficulty urinating (due to prostate problems).
- Methotrimeprazinemay cause a condition affecting heart rhythm (QT prolongation), potentially leading to serious, rarely fatal, fast/irregular heartbeat and other symptoms (like severe dizziness, fainting) requiring immediate medical attention. The risk of QT prolongation may increase with certain medical conditions or if taking drugs that can cause QT prolongation. Inform your doctor or pharmacist about all medications you are taking and any relevant medical conditions.
- This medication can induce dizziness, drowsiness, or blurred vision. Alcohol or marijuana can intensify these effects.
- Avoid activities requiring alertness or clear vision, including driving and using machinery.
- Methotrimeprazinemay increase sensitivity to the sun. Limit sun exposure, avoid tanning booths and sunlamps, and use sunscreen with protective clothing when outdoors. Report sunburn or skin blisters/redness promptly.
- The medication may reduce sweating, increasing the risk of heat stroke. Avoid overheating in hot weather, during strenuous activities, or in hot tubs. Stay hydrated, dress lightly, and seek a cool place if overheated. Seek medical help for persistent fever, mental/mood changes, headache, or dizziness.
- Before procedures involving injected dye or surgery, inform your doctor or dentist about all products you use, including prescription drugs, nonprescription drugs, and herbal products.
- Liquid forms of this product may contain sugar and/or alcohol. Caution is advised for those with diabetes, alcohol dependence, or liver disease. Consult your doctor or pharmacist for safe use.
- Older adults may be more sensitive to side effects, including drowsiness, dizziness, lightheadedness, difficulty urinating, severe constipation, and QT prolongation.
- During pregnancy, use this medication only when necessary. Infants born to mothers who used this drug during the last 3 months of pregnancy may rarely exhibit symptoms such as muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. Report these symptoms to the doctor immediately.
- Do not discontinue this medication without your doctor’s guidance, especially for untreated mental/mood problems. If planning or suspecting pregnancy, discuss with your doctor the risks and benefits of using this medication.
- It’s unclear if this drug passes into breast milk, but it may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.
Form and Strength
Nozinan is available in the following forms and strengths:
- methotrimeprazine tablet:
- 2 mg
- 5 mg
- 25 mg
- 50 mg
FAQ
Is Nozinan good for sleep?
Nozinan is an antipsychotic that is now more commonly used to treat other conditions. It is quite sedating and therefore can be used to help with sleep, although it is not a “sleep medication”.
Why is Nozinan used in palliative care?
Nozinan is indicated in the management of pain and accompanying restlessness or distress in the terminally ill patient.
Resources
- http://www.bcwomens.ca/Specialized-Services-Site/Documents/Complex%20Chronic%20Diseases%20(CCDP)/Methotrimeprazine%20Nozinan%202022.pdf
- https://www.medicines.org.uk/emc/product/1428/smpc#gref
- https://www.medsafe.govt.nz/consumers/cmi/n/nozinan.pdf
- https://go.drugbank.com/drugs/DB01403
- https://www.mayoclinic.org/drugs-supplements/phenothiazine-oral-route-parenteral-route-rectal-route/side-effects/drg-20070394
- https://www.healthlinkbc.ca/medications/levomepromazine-methotrimeprazine-oral
