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Home > Drug Category > Psychiatric Medication > Nozinan and Equivalent

Nozinan (Methotrimeprazine) Information

Nozinan contains the active ingredient methotrimeprazine, a phenothiazine antipsychotic with strong sedative, analgesic, and antiemetic properties. It is used in the management of schizophrenia, severe agitation, and psychosis. It is commonly used in palliative care to help control pain that is difficult to manage with opioids alone, persistent nausea and vomiting, severe restlessness, and terminal agitation. In hospital settings, nozinan injection may be used when rapid symptom control is needed or when the patient is unable to take oral medication. It is administered by trained doctors, typically via intramuscular (IM) injection. Dosing is individualized and depends on your condition and response to treatment.

The mechanism of action for methotrimeprazine involves blocking multiple receptors in the central nervous system. It strongly blocks dopamine receptors, which helps reduce psychosis and agitation. It also blocks several serotonin, histamine, alpha-adrenergic, and muscarinic receptors, which contribute to its sedative, anti-nausea, and analgesic effects. Its broad receptor activity explains why it is highly effective for severe agitation, intractable nausea, and certain types of pain, but it also accounts for its strong sedation and the need for careful monitoring.

Nozinan Side Effects

Nozinan is effective for severe symptoms but has a strong sedative profile, and some common side effects may occur. Commonly reported effects include drowsiness, dizziness, low blood pressure (especially when standing), dry mouth, constipation, blurred vision, increased appetite, and weight gain. Because of its sedating properties, some individuals may feel sluggish or unsteady, increasing the risk of falls, particularly in older adults. Injection-site discomfort may also occur.

More serious side effects can occur, leading to significant monitoring protocols. If you experience any of the following symptoms, stop taking the medication and seek immediate medical attention:
• Irregular heart rhythms: Palpitations, sudden dizziness, or fainting
• Jaundice: Yellowing of the skin or eyes, indicating possible liver involvement
• Neuroleptic Malignant Syndrome (NMS): High fever, muscle stiffness, confusion, sweating, or rapid heartbeat
• Seizures
• Severe allergic reactions: Difficulty breathing, swelling of the face or throat, rash
• Severe anticholinergic effects: Extreme confusion, inability to urinate, severe constipation
• Severe low blood pressure: Fainting, dizziness, or collapse
• Sudden mood or behavioral changes, including agitation or severe confusion
• Tardive Dyskinesia (TD): Involuntary movements of the face, tongue, or limbs

Nozinan Precautions

Do not use nozinan if you are allergic to methotrimeprazine, other phenothiazines, or any of the ingredients in the ampoule. Before receiving this medication, it is essential to inform your doctor of your complete medical history. People with heart disease, low blood pressure, a history of fainting, slow heart rhythms, liver disease, glaucoma, enlarged prostate, severe breathing problems, or seizure disorders may require careful monitoring or dose adjustments. Because nozinan can cause significant sedation, individuals with conditions affecting consciousness or those receiving other sedating medications should use it only under close supervision.

Tell your doctor about all medications you take, including prescription drugs, over-the-counter products, herbal supplements, and vitamins. Nozinan interacts with many medicines, including other sedatives, opioids, antidepressants, antipsychotics, antihistamines, and medications that affect heart rhythm. These interactions can increase sedation, respiratory depression, or the risk of dangerous heart rhythm changes. Avoid alcohol because it can lead to profound sedation and dangerously low blood pressure.

Inform your doctor if you are pregnant or planning to become pregnant. Because phenothiazine antipsychotics may affect the newborn if used in the later stages of pregnancy, nozinan is used during pregnancy only when clearly necessary. If you are breastfeeding or planning to breastfeed, discuss with your doctor, as methotrimeprazine can pass into breast milk and may cause excessive sedation in the infant. Nozinan is administered only by doctors via intramuscular injection to ensure correct dosing and monitoring. The dose and frequency depend on the condition being treated. Lower doses are used for nausea or agitation, while higher doses may be used for psychotic symptoms or severe pain in palliative care. Because nozinan is strongly sedating, patients are typically monitored after administration for changes in blood pressure, breathing, and level of alertness. You should not take this medication by any route other than the one prescribed by your doctor.

Do not abruptly stop nozinan unless directed by your doctor, particularly if you have been receiving repeated doses. Stopping suddenly may lead to withdrawal symptoms or return of agitation or nausea. After receiving the injection, avoid activities that require alertness, such as driving or operating machinery, until the medication has fully worn off. Store nozinan ampoules at room temperature, away from heat, moisture, and light, and out of reach of children. Ampoules should be used only by trained professionals and disposed of safely.

Do I need a prescription to order Nozinan?

Yes, a prescription is required from your physician to order Nozinan.