Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

phentolamine (Rx)Brand and Other Names:Regitine, OraVerse

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

powder for injection

  • 5mg

injectable solution

  • 0.4mg/1.7mL
more...

Pheochromocytoma

Diagnosis: 5 mg IV/IM

Test for pheochromocytoma is positive if decrease SBP >35 mmHg & decrease DBP >25 mmHg

Pheochromocytoma Surgery Use

Treatment of hypertension during pheochromocytoma surgery

5 mg IV/IM 1-2 hr preoperative, repeat if necessary q2-4hr

Extravasation Treatment

Epinephrine or norepinephrine extravastation treatment

Treatment: 5-10 mg in 10 mL NS local injection within 12 hr

Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected)

Dental Anesthesia Reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)

1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

2 cartridges local anesthetic: OraVerse 2 cartridges (0.8 mg)

Hypertensive Crises (Off-label)

Secondary to catecholamine excess: 5-15 mg IV

Other Indications & Uses

Pheochromocytoma diagnosis, HTN in pheochromocytoma surgery, dermal necrosis due to epinephrine/NE extravasation

Off-label: hypertensive crises (pheochromocytoma, other catecholamine excess situations); erectile dysfunction (intracavernous)

Dosage Forms & Strengths

powder for injection

  • 5mg

injectable solution

  • 0.4mg/1.7mL
more...

Pheochromocytoma, Diagnosis

0.1-0.2 mg/kg IV/IM, OR 1 mg IV OR 3 mg IM 

Pheochromocytoma Surgery Use

Treatment of hypertension during surgery

0.05-0.1 mg/kg/dose OR 1 mg IV/IM 1-2 hr preoperative, repeat q2-4hr until hypertension is controlled; not to exceed 5 mg/dose 

Dental Anesthesia Reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor

<6 years or <15 kg: Safety and efficacy not established

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

6-12 years (15-30 kg)

  • For 1/2 cartridge local anesthetic, use OraVerse 1/2 cartridge (0.2 mg)

6-12 years (>30 kg)

  • 1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)
  • 1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

Other Information

Extravasation of epinephrine/norepinephrine:0.1-0.2 mg/kg to no more than 10 mg

Pheochromocytoma

Diagnosis: 5 mg IV/IM

Test for pheochromocytoma is positive if decrease SBP >35 mmHg & decrease DBP >25 mmHg

Pheochromocytoma surgery use

Treatment of hypertension during pheochromocytoma surgery

5 mg IV/IM 1-2 hr preoperative, repeat if necessary q2-4hr

Extravasation treatment

Epinephrine or norepinephrine extravastation treatment

Treatment: 5-10 mg in 10 mL NS local injection within 12 hr

Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected)

Dental anesthesia reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor  

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)

1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

2 cartridges local anesthetic: OraVerse 2 cartridges (0.8 mg)

Next

Interactions

Interaction Checker

phentolamine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            1-10%

            Nasal congestion (10% )

            Post-treatment pain (up to 10% )

            Injection site pain (4% to 6% )

            Diarrhea (<3% )

            Frequency Not Defined

            Cardiac dysrhythmia

            Chest pain

            Hypotension

            Myocardial infarction

            CVA - cerebrovascular accident due to cerebral artery occlusion

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity; MI or other CAD

            Cautions

            First dose effect may occur, causing a sudden and drastic fall in blood pressure after administering the first dose.

            Hypotension/syncope with first few doses or with increase in dose

            Minimize by using small first dose at bedtime

            Increase dose slowly

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk; not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Has positive inotropic and chronotropic effect on the heart

            Blocks alph-adrenergic receptors to briefly antagonize circulating epinephrine and norepinephrine to reduce hypertension caused by alpha effects of the endogenous catecholamines

            Pharmacokinetics

            Half-Life:19 min (IV)

            Duration: 30-45 min (IM); 15-30 min (IV)

            Excretion: Urine (13%) as unchanged drug

            Metabolism: Hepatic

            Onset of action: Immediate (IV); 15-20 min (IM)

            Peak effect: 10-20 min (OraVerse)

            Previous
            Next

            Administration

            IV Compatibilities

            Additive: cibenzoline succinate, dobutamine, verapamil

            Syringe: papaverine

            Y-site: amiodarone

            IV Preparation

            Reconstitute with 1 mL SWI (5 mg/mL solution)

            IV/IM Administration

            Administer by IV or IM injection

            Rapid IV

            Storage

            Store at controlled room temperature

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.