mecamylamine (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 2.5mg

Hypertension

Indicated for moderately severe-to-severe essential hypertension and uncomplicated malignant hypertension

2.5 mg PO BID intially; may increase by 2.5 mg increments at interval not less than 2 days

Average total daily dose is 25 mg (in 3 divided doses); however, as little as 2.5 mg/day may be sufficient

Administration

Take after meals; may cause more gradual absorption and smoother control of excessively high blood pressure

Safety and efficacy not established

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Interactions

Interaction Checker

and mecamylamine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (1)

              • lofexidine

                lofexidine, mecamylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              Monitor Closely (1)

              • xipamide

                xipamide increases effects of mecamylamine by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (13)

              • agrimony

                agrimony increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • bethanechol

                mecamylamine, bethanechol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • brimonidine

                brimonidine increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • cornsilk

                cornsilk increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • forskolin

                forskolin increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • maitake

                maitake increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • niacin

                niacin, mecamylamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypotension.

              • octacosanol

                octacosanol increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • reishi

                reishi increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • shepherd's purse

                shepherd's purse, mecamylamine. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.

              • tizanidine

                tizanidine increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • treprostinil

                treprostinil increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • vasopressin

                mecamylamine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Common

              • Orthostatic hypotension
              • Dizziness, lightheadedness
              • Fatigue
              • Sedation
              • Constipation
              • Dry mouth
              • Nausea/Vomiting
              • Xerostomia

              Serious

              • Syncope
              • Seizure
              • Tremor
              • Paralytic ileus
              • Chorea
              • Dysuria
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              Warnings

              Contraindications

              Hypersensitivity to mecamylamine

              Coronary insufficiency, glaucoma, recent MI, pyloric stenosis, renal insufficiency, uremia

              Do not use w/antibiotics, sulfonamides

              Cautions

              Arteriosclerosis, bladder neck obstruction, urethral stricture, cerebral insufficiency, gastrointestinal obstruction, prostatic hypertrophy

              Potentiation of hypotensive effects due to excessive heat, fever, infection, hemorrhage, pregnancy, anesthesia, alcohol consumption, salt depletion, or diarrhea

              Avoid abrupt withdrawal

              Rarely used

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: may cross into the breast milk, use caution

              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.

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              Pharmacology

              Mechanism of Action

              Ganglionic blocker, inhibits acetylcholine at autonomic ganglia resulting in decreased blood pressure

              Pharmacokinetics

              Half-Life: 24 hr

              Onset: 0.5-2 hr

              Duration: 6-12 hr

              Excretion: urine 100%

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Vecamyl oral
              -
              2.5 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              mecamylamine oral

              MECAMYLAMINE - ORAL

              (MEK-a-MIL-a-meen)

              COMMON BRAND NAME(S): Vecamyl

              USES: Mecamylamine is used to treat moderately severe to severe high blood pressure. It can also be used in sudden high blood pressure emergencies (malignant hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Mecamylamine belongs to a class of drugs known as ganglion blockers. It works by relaxing blood vessels so blood can flow more easily.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually 2 to 3 times daily. You may take this medication with or without food, but it is important to choose one way and take this medication the same way with every dose.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Do not stop taking this medication without consulting your doctor. A rapid rise in blood pressure may occur when this drug is suddenly stopped. This rapid rise in blood pressure may lead to stroke or heart failure that can be severe (possibly fatal). To prevent your blood pressure from getting too high if you are stopping treatment with this drug, your doctor may reduce your dose gradually and start you on another medication. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.It is important that you do not run out of mecamylamine or miss any doses. Tell your doctor or pharmacist right away if you are unable to take the medication (for example, due to vomiting).When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well. Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings remain high or increase).

              SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, tiredness, blurred vision, decreased sexual ability/interest, nausea, constipation, and dry mouth may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Hot weather, exercise, or alcohol may increase dizziness and lightheadedness. Fever, vomiting, diarrhea, bleeding, loss of salt, or heavy sweating may also increase dizziness. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, difficulty urinating, shaking (tremor), uncontrolled movements of the face/hands/arms/legs, numb/tingling skin.If you develop frequent diarrhea with severe stomach/abdominal discomfort and/or bloating while taking this medication, get medical help right away. This may be a sign of a very serious bowel disease (paralytic ileus).Get medical help right away if you have any very serious side effects, including: mental/mood changes (such as anxiety, confusion, depression), seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking mecamylamine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: glaucoma, narrowing of the opening from stomach into intestines (organic pyloric stenosis), heart problems (such as chest pain, heart attack), blood flow problems especially to the brain (such as stroke), kidney disease, bladder/urination problems (such as bladder neck obstruction, urethral stricture), enlarged prostate (prostatic hypertrophy), salt-restricted diet.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: ambenonium.Other medications can affect the removal of mecamylamine from your body, which may affect how mecamylamine works. Examples include urinary alkalinizers (sodium/potassium citrate), sodium bicarbonate, among others.Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness or increase your blood pressure. Ask your pharmacist about using those products safely.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe weakness, severe/sudden nausea and vomiting, anxiety, pounding heartbeat.

              NOTES: Do not share this medication with others.Lifestyle changes that may help this medication work better include exercising, stopping smoking, and eating a low-cholesterol/low-fat diet. Consult your doctor for more details.Lab and/or medical tests (such as blood pressure readings, kidney function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Have your blood pressure checked regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised November 2022. Copyright(c) 2022 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              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.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.