Uses of Kestolac

Kestolac belongs to the group of psychotropic drugs, the main active ingredient is Levosulpiride. Kestolac is available in the form of tablets with a strength of 25mg.
Levosulpiride belongs to the benzamide group, is the transmission isomer of sulpiride. Levosulpiride has antipsychotic effects through selective blockade of dopamine D2 receptors in the brain. Levosulpiride can be considered as an intermediate between neuroleptics and antidepressants because Levosulpiride has both effects.

2.1.Indications Kestolac is indicated for use in relieving symptoms of functional dyspepsia: epigastric discomfort, abdominal distension, belching, heartburn, nausea, vomiting. In addition, Kestolac is also used in the treatment of acute and chronic schizophrenia.
2.2.Contraindications Kestolac is contraindicated for use in the following cases:
Allergy or hypersensitivity to Levosulpiride or any of its ingredients. Adrenal myeloma. Acute porphyria metabolism disorder. Central nervous system depression, alcohol intoxication, coma, and use of neuroleptics.

Kestolac is used orally with the following dosage:
Adults
Relieve symptoms of functional dyspepsia: 1 tablet x 3 times/day. Treatment of acute and chronic schizophrenia: 200-300mg/day, divided into 3 times/day. Children
Children 14 years of age and older when using the drug need to reduce the dose. Children under 14 years old: there is no indication for using Kestolac in this subject. Patients with renal impairment
When Kestolac is used in patients with renal impairment, the dose should be reduced or the dosing interval increased, depending on the creatinine clearance.
Creatinine clearance 30 - 60 ml/min: the dose is 2/3 of the normal dose. Creatinine clearance 10 - 30 ml/min: dose equal to 1/2 of the normal dose. Clearance less than 10 ml/min: the dose is 1/3 of the normal dose. Or it is possible to increase the interval between doses by 1.5; 2 and 3 times more than usual. However, in patients with moderate to severe renal impairment, it is best not to take Levosulpiride.

Levosulpiride overdose symptoms are common when using doses from 1 to 16g, but so far there have been no reports of death even with doses up to 16g. Clinical symptoms vary depending on the dose administered.
Levosulpiride dose: 1 - 3g can cause a state of dark consciousness, restlessness and rarely extrapyramidal symptoms. Doses of 3-7g cause more confusion, agitation and extrapyramidal syndrome. Doses > 7g in addition to the above symptoms may cause coma and hypotension. Overdose symptoms usually resolve within a few hours. The coma seen with high doses of levosulpiride may persist for up to 4 days.
Treatment of Kestolac drug overdose: currently there is no specific antidote for Levosulpiride, the main treatment measures apply supportive and symptomatic treatment. In case of overdose of Kestolac, it is possible to apply gastric lavage immediately, or give the patient activated charcoal when vomiting drugs do not work, alkalinize the urine to increase drug elimination. If necessary, medications can be used to treat Parkinson's syndrome.

Some symptoms may be encountered when using Kestolac such as:
Common: insomnia, or drowsiness, menstrual disorders, hyperprolactinemia, increased lactation. Uncommon: overstimulation, extrapyramidal syndrome, Parkinson's syndrome. Prolonged QT interval (causing arrhythmias, torsades de pointes). Rare: tardive dyskinesia, neuroleptic malignant febrile syndrome, bradycardia, arrhythmia, orthostatic hypotension, hypothermia, photosensitivity, cholestatic jaundice. When symptoms of overdose become severe, it is necessary to stop using Kestolac and seek medical attention.

Patients with renal impairment, the dose of Levosulpiride should be reduced and careful monitoring during dosing. Patients with severe renal impairment should be given intermittent therapy. Close monitoring when using Kestolac drug in the following subjects:
Epilepsy patients: there is a possibility of lowering the seizure threshold. Elderly: increased risk of orthostatic hypotension, somnolence and occurrence of extrapyramidal effects. High fever of unknown cause: Kestolac should be discontinued to rule out neuroleptic malignant syndrome. Patients with hypomania: Low doses of Levosulpiride may worsen symptoms. Ability to drive and use machines: Using Kestolac can cause dizziness or nervous disorders. Therefore, caution should be exercised when driving or operating machinery while taking Kestolac.
Pregnant women : Levosulpiride has the ability to cross the placenta, so the drug may cause unwanted effects on the fetus's nerves. Kestolac should not be used during pregnancy, especially during the first 16 weeks of pregnancy.
Lactation: Levosulpiride is excreted into breast milk in relatively large amounts, which may cause undesirable effects in the nursing infant. Therefore, consider not taking the drug or stopping breastfeeding while taking Kestolac.

Sucralfate, antacids containing aluminum or magnesium hydroxide: may reduce the absorption of Levosulpiride. Patients should take Kestolac 2 hours after taking the antacid to avoid drug interactions. Other CNS depressants: Increases the CNS depressant effect which may have undesirable consequences when used with Levosulpiride. Levodopa: This is a competitive antagonist of Levosulpiride and neuroleptics, so the combination of Levosulpiride and Levodopa is contraindicated. Alcohol: Concomitant use with Kestolac increases the sedative effect of the drug. Avoid drinking alcohol and using alcoholic beverages while taking Levosulpiride. Lithium: Increases the likelihood of extrapyramidal disorders of Levosulpiride, possibly because lithium increases the binding of Levosulpiride to dopaminergic D2 receptors in the brain. Antihypertensives: Concomitant administration of Levosulpiride may increase the antihypertensive effect and the occurrence of orthostatic hypotension. Kestolac belongs to the group of psychotropic drugs, the active ingredient of which is Levosulpiride. Kestolac is used in the treatment of symptoms of functional dyspepsia and in the treatment of acute and chronic schizophrenia. To ensure the effectiveness of treatment and avoid unwanted side effects, patients need to strictly follow the instructions of the doctor, professional pharmacist.
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