Is edema a known side effect of Nozinan (levomepromazine)?/nA 41-year-old man who has been treated

Fråga: Is edema a known side effect of Nozinan (levomepromazine)?

A 41-year-old man who has been treated with Nozinan (two tablets at night) for three weeks developed edema in his face and legs since two weeks ago. The patient is also taking the following medications: Cipramil 20 mg x1 for one year, Antabus 400 mg x1 and Alprazolam 2 mg x3 for three months; Tendanex for asthma and Alvedon plus ASA for pain in the neck.

Sammanfattning: Although edema and water intoxication have been reported to be associated with the treatment with some of the neuroleptics, no such report has been found for levomepromazine in the literature. However, it cannot be excluded in the present case that the edema may be associated with levomepromazine intake.

Svar: A thorough literature search did not find any report on edema and water intoxication caused by levomepromazine treatment. However, polydipsia and water intoxication associated with treatment with different neuroleptics such as thioridazine, zuclopenthixol and haloperidol (1-5) have been reported in literature and documented in Drugline. A suspected mechanism for water intoxication is the development of SIADH (syndrome of inappropriate secretion of antidiuretic hormone) (4). Four cases of edema associated with levomepromazine treatment have been reported to The Swedish Adverse Drug Reactions Advisory Committee (SADRAC) where the association between the side-effect and the drug treatment was judged possible in all the four cases.

We recommend that the present case should be reported to SADRAC. 1 Drugline nr 05891 (year 1987)
2 Drugline nr 05353 (year 1985)
3 Drugline nr 05218 (year 1986)
4 Drugline nr 03082 (year 1982) (enclosed)

5 Drugline nr 09032 (year 1991) (enclosed)