Levogastrol (Levosulpiride) in Spain: Uses and Safety

Levogastrol is a prescription medicine in Spain that contains levosulpiride (levosulpirida). It is used for a short time for indigestion caused by a slow-emptying stomach, for sickness from cancer treatment, and for dizziness and sickness in Ménière's disease, when other treatments have not worked. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).

What is levosulpiride used for?

The Spanish product information lists three uses, all short term:

• indigestion (upper tummy discomfort, feeling full, nausea) caused by slow stomach emptying, when other treatments have not worked;
• nausea and vomiting caused by cancer medicines, when first-line treatment has failed;
• dizziness, ringing in the ears, hearing loss and nausea in Ménière's disease.

It is not an antacid. If your problem is heartburn or reflux, read about heartburn first.

How does levosulpiride work?

It is a benzamide that blocks a brain and gut chemical called dopamine. In the gut, this helps the stomach empty sooner and calms nausea. It is the "levo" form of sulpiride, from the same family. It works in a similar way to metoclopramide (Primperan), but the two are not interchangeable.

Do you need a prescription for Levogastrol in Spain?

Yes. In Spain it is sold only with a prescription. Before prescribing it, a doctor rules out other causes of your symptoms, such as an ulcer, a Helicobacter infection, gallbladder problems or side effects of other medicines.

How is Levogastrol taken?

Swallow the tablets whole with water, before meals. Do not split or chew them. Your dose and how long to take it are set by the prescription and explained in the leaflet; ask your pharmacist if you are unsure. The product information does not advise long-term non-stop use: it is taken for a few weeks and then reviewed. The tablets contain lactose.

Who should not take Levogastrol?

• People allergic to levosulpiride or any of the ingredients.
• People with epilepsy or past fits.
• People with mania, or bipolar disorder in a manic phase.
• People with bleeding, blockage or a tear in the gut, or a risk of these.
• People with a phaeochromocytoma (a tumour of the adrenal gland).
• People with breast cancer.
• Women who are pregnant or breastfeeding.

Its safety and benefit in children have not been shown.

What are the side effects?

Side effects are not common. It can cause drowsiness, dizziness, poor sleep, shaking or constipation. Because it raises prolactin, it can cause milk from the nipple, breast growth in men, breast pain or changes to periods. Rarely, it causes stiffness or movements you cannot control, like those in Parkinson's.

Very rarely it causes neuroleptic malignant syndrome: high fever, stiff muscles, sweating and confusion. This is an emergency. Stop the medicine and call 112.

Can I drink alcohol or take other medicines with it?

Avoid alcohol while you take it. Strong painkillers (opioids) and anticholinergic medicines can weaken its effect. Tell your doctor if you take other medicines that act on dopamine, such as antipsychotics or Parkinson's medicines. Always tell your doctor about all your medicines.

Can I drive while taking it?

It can cause drowsiness, dizziness and blurred vision. Do not drive or use machines until you know how it affects you.

In English: what is the equivalent?

Levosulpiride is not licensed in the UK or the US, so you will not find Levogastrol there. Doctors in those countries use other medicines for these problems, such as metoclopramide or domperidone. They are different medicines with their own rules, so do not swap one for another without a doctor. In a Spanish pharmacy, ask for Levogastrol or levosulpirida, with a prescription from a doctor licensed in Spain.

When to see a doctor

• Stomach symptoms last more than a few weeks or come back when you stop.
• You notice milk from the nipple, breast growth or changes to your periods.
• You get shaking or movements you cannot control.
• You lose weight without trying or find it hard to swallow.

When to call 112

• High fever with stiff muscles, sweating or confusion.
• Vomiting blood or black stools.
• A fit (seizure).
• Swelling of the face, lips or tongue, or trouble breathing.

Frequently asked questions about Levogastrol

Getting a medical assessment

If you have slow digestion or nausea and want a doctor's view, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about acid reflux and omeprazole without a prescription. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.