Amizal

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Amizal

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Amizal

Understanding Amizal

Amizal is a pharmaceutical medication classified as an atypical antipsychotic. It contains the active substance amisulpride. Unlike older generations of antipsychotic medications, Amizal belongs to a class that selectively interacts with specific dopamine receptors in the brain to help manage symptoms related to mood and thought processes.

How It Works

The medication works by binding to dopamine D2 and D3 receptors. Dopamine is a chemical messenger, or neurotransmitter, that plays a significant role in how the brain regulates behavior, emotions, and perception. By modulating the activity of these receptors, Amizal helps to balance dopamine signaling.

Amizal is unique because its effect on the brain can vary depending on the amount present in the system:

  • At lower levels: It primarily blocks receptors that regulate the release of dopamine, which can help improve symptoms related to withdrawal or low motivation.
  • At higher levels: It acts more directly on the receptors responsible for overactive signaling, which helps reduce symptoms such as disordered thinking or sensory disturbances.

Clinical Uses

Amizal is primarily used in the management of schizophrenia. This is a long-term mental health condition that affects how a person thinks, feels, and behaves. The medication is designed to address two distinct types of symptoms associated with the condition:

  • Positive Symptoms: These include experiences that are "added" to a person's reality, such as hallucinations (hearing or seeing things that are not there), delusions (fixed false beliefs), and disorganized thinking.
  • Negative Symptoms: These refer to qualities that are "taken away" from a person's usual functioning, such as a lack of emotional expression, reduced speech, social withdrawal, and a diminished ability to experience pleasure or motivation.

In some clinical contexts, the active ingredient in Amizal may also be utilized for other mood-related conditions, depending on the specific needs of the patient and the assessment of a healthcare provider.

What side effects are possible with Amizal?

Possible Side Effects and Safety Information

The safety profile of Amizal (Idebenone) is formally classified by regulatory authorities, with adverse reactions grouped by frequency and the body system affected. These classifications ensure a neutral communication of risks documented during clinical use.

Adverse Reaction Frequencies

Side effects are categorized according to regulatory standards (e.g., CIOMS convention):

Classification Examples of Reactions
Very Common (ge 1/10) Nasopharyngitis, Cough
Common (ge 1/100 to < 1/10) Diarrhoea, Back pain, Nausea, Vomiting

Adverse effects are documented across various System-Organ Classes (SOC), including Infections and Infestations, Gastrointestinal Disorders, Nervous System Disorders, and Hepatobiliary Disorders.

Serious Adverse Reactions

Specific serious adverse reactions are listed in official labeling, although their frequency may be classified as Not Known (cannot be estimated from available data). These include Hepatitis and other severe Liver Function Abnormalities, as well as serious Blood Count Abnormalities such as Agranulocytosis. Certain Nervous System Disorders, including Seizure, Delirium, and Hallucinations, are also documented as potential critical reactions.

Safety Considerations and Restrictions

Safety notes explicitly advise caution in specific patient groups. Safety and efficacy have not been established in pediatric patients under 12 years of age. Caution is also advised in patients with hepatic or renal impairment due to limited data, with adverse events leading to discontinuation reported in hepatic impairment. The medicine is contraindicated in individuals with documented hypersensitivity to Idebenone or any excipients. A harmless reddish-brown discoloration of the urine (chromaturia) may occur due to the drug's metabolites.

Overdose and Emergency Response

Overdose and When to Seek Help

This section outlines the official regulatory information regarding an overdose of Amizal (Idebenone).


Documented Overdose Profile

Regulatory documentation indicates that specific clinical experience with acute overdose of Idebenone is limited. In official clinical studies, no specific symptoms or clinical signs of overdose were reported, and the label explicitly states that no report of overdose has been received in key trials. The safety profile observed at high doses, up to 2,250 mg/day (above the therapeutic dose), was consistent with the known adverse reactions listed for the medicine.


Emergency Actions and Management

In the event of a suspected or actual overdose, seeking professional medical attention is the officially required action. You must contact a physician or local emergency services immediately for advice.

Management Aspect Official Regulatory Information
Documented Symptoms None formally reported in clinical trials.
Specific Antidote No specific antidote is available.
Procedural Steps Management is limited to general symptomatic and supportive treatment.

No specific population-based considerations (e.g., for children or the elderly) regarding overdose severity are formally described in the official prescribing information.

Therapeutic Uses of Amizal

Amizal is applied across domains where additional symptomatic support is needed, primarily within neurological and mitochondrial disease contexts. Its use is focused on conditions presenting with systemic or localized discomfort and functional strain. It supports therapeutic benefits aimed at stabilizing or improving specific symptom patterns.


This medication is primarily used to address visual impairment in adolescent and adult patients with Leber's Hereditary Optic Neuropathy (LHON), and may be part of symptomatic management applied in clinical settings that involve sequelae of cerebrovascular disorders or progressive conditions like Duchenne Muscular Dystrophy (DMD). It is relevant for managing symptom clusters that interfere with daily comfort, such as loss of central vision, or symptoms related to increased neurological or muscular activity.

“Amizal supports general well-being and is used for managing symptoms that create noticeable physiological strain during difficult episodes.”

Quick Fact: Relief for Functional Strain

Amizal is considered relevant in clinical settings that involve acute or unstable symptom patterns, such as during phases of post-stroke recovery or periods of acute central vision loss. It supports patients during difficult episodes by easing distress and assists with maintaining functional stability.

Eligibility and Restrictions for Use

Official Eligibility Profile for Amizal (Idebenone)

Official regulatory documents strictly define the patient populations permitted and prohibited from using Amizal, based on established data and contraindications. Amizal is established for use in adults and adolescents 12 years of age and older who have Leber's Hereditary Optic Neuropathy (LHON).

Use is contraindicated in patients with a known hypersensitivity to Idebenone or any of the excipients. Absolute prohibition also applies to patients with specific hereditary conditions, including rare problems of galactose intolerance, Lapp lactase deficiency, and glucose-galactose malabsorption.

Use is not established for pediatric patients under 12 years of age. For individuals with hepatic or renal impairment, regulatory documentation advises Caution because these specific patient populations have not been fully investigated. Use during pregnancy and lactation is also restricted; a decision must be made to either discontinue the medicine or discontinue breastfeeding, as safety is not established.

What should I know about interactions with other medicines?

Interactions with Other Medicines and Products

This section summarizes interactions with Amizal that are officially documented in authoritative government regulatory information, including the resulting mandatory clinical constraints.

Clinically Significant Interactions

Classification Interacting Product Category Regulatory Constraint Interaction Basis
Efficacy-Lowering Interaction Hormonal Contraceptives Use of alternative, non-hormonal methods is required. Amizal is documented to lower the efficacy of birth control pills (oral contraceptives).
Safety Clarification Alcohol No restriction is required for concomitant use. Official documentation states that Amizal is safe for use with alcohol.

Official Regulatory Requirements

Amizal’s interaction profile requires specific actions when used by females of reproductive potential. Official regulatory texts mandate that women must be advised about the potential for contraceptive failure when using hormonal birth control pills concurrently with Amizal. Therefore, individuals are instructed to use other methods of contraception (such as condoms, diaphragms, or spermicides) during treatment to ensure effective birth control. This constraint is based strictly on the officially documented effect of Amizal on the efficacy of hormonal products. No explicit timing separation rules are documented for absorption interference.

Mechanism of Action

How Amizal Works: Mechanism of Action

Amizal exerts its pharmacodynamic action by targeting and irreversibly inhibiting bacterial Penicillin-Binding Proteins (PBPs) . These enzymes, which are located on the bacterial cell membrane, are essential transpeptidases that catalyze the final cross-linking step of peptidoglycan chain assembly. Peptidoglycan forms the rigid, protective cell wall structure unique to bacteria.

By covalently binding to the PBPs, the medication arrests this crucial cross-linking process, resulting in the formation of a structurally defective cell wall. This structural compromise renders the bacterial cell unstable and highly vulnerable to external osmotic pressure. The resulting physiological consequence is the rapid influx of water, causing the bacterial cell to rupture and die, a process known as cell lysis.

Dosage and Administration Information

Amizal, containing the active substance idebenone, is administered through the oral route as a film-coated tablet, following a structured, multi-dose daily regimen. The standard recommended total daily intake for adults and adolescents aged 12 years and over is 900 mg of idebenone.

This required dosage is split into three equal administrations of 300 mg, which corresponds to two 150 mg tablets per intake, taken three times per day. A critical instruction for proper use is that the medication must be administered with food to enhance the absorption of the active substance. Each dose should be swallowed whole with water, and the tablets must not be broken, crushed, or chewed.

Treatment with Amizal is typically continuous, reflecting its long-term pattern of use, with available data supporting administration for durations up to 24 months. The initiation of therapy requires the supervision of a physician experienced in treating the relevant condition. If a dose is forgotten, the procedure is to skip the missed dose and take the next dose at its regularly scheduled time; a double dose must not be taken to compensate for the omission. No specific dose adjustment is necessary for older adult patients.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Amizal (Idebenone)


Evidence for Use in Leber's Hereditary Optic Neuropathy (LHON)

A significant portion of the research for Amizal involves its evaluation for visual impairment in patients with Leber's Hereditary Optic Neuropathy (LHON). Research includes large Randomized Controlled Trials (RCTs) and long-term follow-up studies that monitor outcomes related to visual acuity (VA) and the rate of achieving a Clinically Relevant Benefit (CRB). These studies primarily focused on adolescents and adults with specific mitochondrial DNA mutations. The findings describe patterns where the measured outcomes for patients initiating the medicine during the subacute phase (within the first year of vision loss) differed compared to those measured in the chronic phase. While the initial RCTs did not always reach their primary endpoint goals for VA change, subsequent analyses and long-term data show patterns related to the measurement of vision outcomes in some individuals. However, long-term effects are not fully established based on the controlled trials.


Evidence for Use in Duchenne Muscular Dystrophy (DMD)

Amizal was studied for its use in Duchenne Muscular Dystrophy (DMD) through large-scale Phase 3 RCTs and observational extensions. Research primarily focused on male patients, typically adolescents, examining outcomes related to respiratory function (PEF and FVC). Data points related to the rate of decline in certain respiratory measures, like PEF, were observed to be lower in the group receiving the medicine compared to the placebo group over the study period. A key limitation is that many core RCTs excluded patients already receiving glucocorticoid therapy, meaning the results apply primarily to those populations studied.


Research Gaps and Uncertainty

For conditions like the sequelae of cerebrovascular disorders, the evidence base relies primarily on non-randomized studies, often involving smaller cohorts. In these settings, the certainty remains low because comparative evidence is lacking. Overall, long-term outcomes are not strictly controlled beyond initial trials. Furthermore, subgroup findings are uncertain regarding patients with atypical mutations or those with significant comorbidities, as these groups were often excluded from the controlled research.

Key Studies & References

  1. Efficacy and safety of idebenone in patients with Duchenne muscular dystrophy (SYROS): a non-randomised, open-label, extension study

Frequently Asked Questions (FAQ)

Common questions about Amizal (FAQ)

Q: Is Amizal the same type of medicine as [similar drug name]?

Amizal is classified in regulatory documents as a Psychoanaleptic, which belongs to a group of psychostimulants and nootropics. Its active ingredient, Idebenone, is a man-made compound designed to be a synthetic analogue of the naturally occurring substance Coenzyme Q10. This classification helps define the unique mechanism of action of the medicine.

Q: How long does it usually take for Amizal to start working?

Label information suggests that the time taken to observe a benefit can vary. For its primary approved use, clinical trial data indicated initial recovery of visual function in some patients within approximately one month, with further benefits observed up to four months. Ongoing communication with the prescribing physician is appropriate regarding expectations for the onset of effect.

Q: How long can a person safely use Amizal?

Regulatory documents and clinical data show that Amizal is typically used as a continuous, long-term treatment. The available clinical trial data support the administration of the medicine for durations up to 24 months. Any determination of total treatment length is made by the prescribing physician.

Q: Are there different strengths or forms of Amizal available?

According to the official product information, Amizal is standardized as a film-coated tablet for oral use. Each tablet contains 150 mg of the active substance, Idebenone. No other strengths or forms are mentioned in the official product labeling.

Q: What should I know about driving or operating machinery while on Amizal?

Official documents note that Amizal may cause certain side effects, such as dizziness, which may impair coordination. Regulatory information includes a specific warning that if a patient experiences these effects, they should take caution when driving or operating machinery.

Q: Do official documents mention long-term side effects for Amizal?

The safety profile available in regulatory documents is based on data collected from clinical trials that supported continuous use for up to 24 months. Within this data, serious adverse reactions like Hepatitis and Blood Count Abnormalities are documented. However, the exact frequency of these serious reactions is often classified as 'Not known' because it cannot be estimated from the available data.

Q: Why do some people need to take Amizal for a long time?

The continuous nature of treatment relates to the drug's mechanism of action. Amizal works by continuously supporting mitochondrial function and mitigating oxidative damage within specialized cells. This steady, protective action is related to the goal of preserving cellular function over a long period, supporting the continuous treatment regimen.

Q: Do studies show if Amizal is generally well-tolerated?

The documented side effect profile indicates that the most commonly reported adverse reactions are classified as generally mild to moderate. Examples include diarrhoea, nasopharyngitis, and cough. In clinical studies, these reactions did not typically necessitate the discontinuation of treatment, suggesting a generally manageable tolerability profile.

Q: Can I take Amizal if I am currently taking over-the-counter pain relievers?

Official product information states that Idebenone may interact with other medicines. Regulatory guidance advises that individuals communicate their use of all current medications, including any prescription and over-the-counter pain relievers, to their prescribing physician. This communication assists in the assessment of potential interaction risks.

Q: Does Amizal cause weight gain or weight loss?

Official documents mention that an increase in body fat and cholesterol has been documented as a potential side effect, though its frequency is often classified as 'Not known.' Additionally, a separate side effect of loss of appetite has been reported.

Q: Is it normal to feel tired when first starting Amizal?

Regulatory documents list unusual tiredness, weakness, and sleepiness as documented potential side effects. These effects may be experienced when a patient first begins taking the medicine.

Q: Can Amizal affect my sleep schedule?

The official safety information reports that sleep-related effects, specifically sleepiness and difficulty sleeping (insomnia), have been noted as potential adverse reactions.

Q: Do I need to change my lifestyle while I'm using Amizal?

Regulatory documents contain a critical warning concerning contraception for women of reproductive potential. Due to an interaction that lowers the effectiveness of hormonal birth control pills, the official labeling mandates that alternative, non-hormonal contraception methods be used throughout the course of treatment.

Q: Can Amizal cause any issues with my blood pressure?

Official safety notes advise caution for patients with a history of high blood pressure. Regulatory guidance suggests that patients in this group may require regular monitoring of their blood pressure throughout the course of treatment.

Q: Is it possible to develop a dependency on Amizal?

According to official sources, no habit-forming tendencies have been reported for the active ingredient, Idebenone. The medicine is not typically associated with a risk of physical or psychological dependence.

Q: Can I stop taking Amizal suddenly, or do I need to reduce the amount slowly?

Official instructions advise against suddenly stopping Amizal. Any decision regarding the discontinuation of treatment is a clinical matter that is appropriately discussed and managed by the prescribing doctor.

Q: What if Amizal doesn't seem to be working for me after a few weeks?

If there is concern about the expected effects after a few weeks, regulatory guidance suggests maintaining the prescribed regimen. The appropriate course of action is to communicate any concerns about the medication’s effectiveness or progress with the prescribing physician.

Q: Are there any known interactions between Amizal and herbal supplements?

Official warnings advise individuals to communicate their use of all current products, including any herbal products, vitamins, and supplements, with their physician. Potential interactions with other antioxidant supplements have been noted, and this communication assists in safety assessment.

Q: Does Amizal come with a patient information leaflet (PIL)?

Yes, according to standard regulatory practice, the medicine is supplied to the patient with a Patient Information Leaflet (PIL), often referred to as a Package Leaflet. This document contains essential, concise information about the medicine's use and safety profile.

Q: Can taking Amizal affect my mood or anxiety levels?

Official safety information includes Nervous System Disorders among the documented adverse reactions. These include reports of agitation, delirium, and hallucinations (though frequency is not known). Restlessness has also been reported as a potential side effect.

Q: What should I do if I think I have had a bad reaction to Amizal?

In the event of severe side effects or a sudden worsening of existing symptoms, obtaining immediate medical consultation is advised. Additionally, suspected adverse reactions are typically reported by the patient or physician via the relevant national drug reporting system.

Q: Is Amizal a relatively new drug, or has it been used for a long time?

The active ingredient, Idebenone, has been the subject of research for many decades. However, its approval for the primary indication in the European Union is relatively recent, dating to September 2015.

Q: Can Amizal affect my ability to get pregnant?

The official label contains sections addressing fertility, pregnancy, and lactation. Use of the medicine is restricted during pregnancy and lactation. Individuals who are planning to become pregnant are advised to discuss their treatment with their physician.

Q: Is Amizal a controlled substance?

According to available regulatory information, Amizal is not generally classified or listed as a scheduled controlled substance. No habit-forming tendencies have been reported for its active ingredient.

Q: Can I use Amizal if I am allergic to other medications?

The medicine is strictly contraindicated for individuals with a known hypersensitivity or allergy to Idebenone or any of its inactive ingredients. Individuals are advised to communicate all known allergies, including those to other medications, to their physician. This assists in the risk assessment process.

Q: What is the purpose of the boxed warning on Amizal labeling?

Idebenone has not been approved by the US Food and Drug Administration (FDA) for its primary indication. Due to this regulatory status, the medicine does not carry a US Boxed Warning.

Q: What does the FDA label say about Amizal's intended use?

According to official information, Idebenone has not been approved by the US Food and Drug Administration (FDA) for its primary indication. Therefore, a definitive FDA label detailing intended use is not available.

Q: Can Amizal make me feel dizzy or light-headed?

Official safety documents list dizziness as a documented side effect, though its frequency is classified as 'Not known' (cannot be estimated from the available data).

Q: Does Amizal have a 'Black Box Warning' in the US?

Idebenone has not been approved by the US Food and Drug Administration (FDA) for its primary indication. Due to this regulatory status, the medicine does not carry a US Black Box Warning.

Q: What kind of monitoring (like blood tests) is sometimes needed with Amizal?

Regulatory guidelines advise that regular monitoring of liver and kidney function tests may be indicated during treatment with Amizal. This monitoring is suggested due to the documented potential for serious adverse reactions related to these organ systems.

How should Amizal be stored and disposed of?

How to Store and Dispose of Amizal

The storage and disposal of Amizal tablets are governed by official regulatory requirements to maintain product stability and ensure environmental protection.

Storage Conditions

Amizal must be stored in its original package and requires explicit protection from light and moisture. The required maximum storage temperature is below 25 C. The medicine must be kept out of the sight and reach of children as a safety requirement. Stability is tied to the labeled expiry date, and the medicine should not be used if any visible signs of deterioration are present.

Disposal Instructions

Official instructions prohibit the disposal of unused or expired Amizal via wastewater or general household waste. To ensure correct pharmaceutical waste handling and environmental protection, individuals are instructed to consult their pharmacist for guidance on proper disposal procedures.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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