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Resin Haemoperfusion in Levomepromazine Poisoning: Evaluation of Effect on Plasma Drug and Metabolite Levels

Department of Pharmacology, Institute of Medical Biology, University of Tromsø, PO Box 977, N-9001 Tromsø

D. Jacobsen

Medical Department 7 and Division of Clinical Pharmacology and Toxicology, The Central Laboratory, UllevÅl University Hospital, N-0407 Oslo 4, Norway

1 Plasma levels of levomepromazine and two of its major metabolites N-desmethyl-levomepromazine and levomepromazine sulphoxide were studied in two poisoned patients treated with resin haemoperfusion at a constant blood flow of 200 ml/min.

2 The mean haemoperfusion clearance of levomepromazine, N-desmethyl-levomepromazine and levomepromazine sulphoxide was 114, 123 and 151 ml/min, respectively, in patient no. 1, and 153, 148 and 184 ml/min, respectively, in patient no. 2. Patient no. 2 had also ingested amitriptyline, and the mean haemoperfusion clearance of amitriptyline and its metabolite nortriptyline was 183 and 183 ml/min respectively.

3 Haemoperfusion did not seem to alter the elimination profile of levomepromazine or the two metabolites in either patient.

4 We conclude that haemoperfusion is of little value in removing levomepromazine, N-desmethyl-levomepromazine or levomepromazine sulphoxide from the body. This is probably due to the large apparent volume of distribution and the high intrinsic hepatic metabolic clearance of these compounds.

Human & Experimental Toxicology, Vol. 3, No. 6, 497-503 (1984)
DOI: 10.1177/096032718400300604


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