dichlorphenamide (Rx)

Brand and Other Names:Keveyis
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 50mg

Periodic Paralysis

Indicated for primary hyperkalemic periodic paralysis, primary hypokalemic periodic paralysis, and related variants

50 mg PO q12hr; increase or decrease at weekly intervals according to individual response; not to exceed 200 mg/day

Evaluate patient response after 2 months of treatment to decide drug should be continued

Safety and efficacy not established

Periodic Paralysis

Indicated for primary hyperkalemic periodic paralysis, primary hypokalemic periodic paralysis, and related variants

50 mg PO q12hr; increase or decrease at weekly intervals according to individual response; not to exceed 200 mg/day

Evaluate patient response after 2 months of treatment to decide whether drug should be continued

Use lowest effective dose possible, owing to risk increased risk of falls

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Interactions

Interaction Checker

and dichlorphenamide

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Paresthesia (44%)

            Cognitive disorder (14%)

            Dysgeusia (14%)

            Confusional state (11%)

            1-10%

            Headache (8%)

            Hypoesthesia (8%)

            Lethargy (8%)

            Fatigue (8%)

            Muscle spasms (8%)

            Rash (8%)

            Dizziness (6%)

            Diarrhea (6%)

            Nausea (6%)

            Malaise (6%)

            Decreased weight (6%)

            Arthralgia (6%)

            Muscle twitching (6%)

            Dyspnea (6%)

            Pharyngolaryngeal pain (6%)

            Pruritus (6%)

            Postmarketing Reports

            Amnesia

            Cardiac failure

            Convulsion

            Fetal death

            Hallucination

            Nephrolithiasis

            Pancytopenia

            Psychotic disorder

            Renal tubular necrosis

            Stupor

            Syncope

            Tremor

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            Warnings

            Contraindications

            Hypersensitivity to dichlorphenamide or other sulfonamides

            Coadministration with high-dose aspirin

            Severe pulmonary disease, limiting compensation to metabolic acidosis caused by dichlorphenamide

            Hepatic insufficiency; dichlorphenamide may aggravate hepatic encephalopathy

            Cautions

            Fatalities associated with sulfonamides reported; hypersensitivity, anaphylaxis, and idiosyncratic reactions reported and may include Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias; pulmonary symptoms may occur in isolation or as part of a systemic reaction; discontinue at first sign of rash

            Coadministration with high-dose aspirin may result in anorexia, tachypnea, lethargy, and coma (also see Contraindications)

            Hypokalemia reported; monitor potassium levels periodically; risk is greater when dichlorphenamide is used with conditions associated with hypokalemia (eg, adrenocortical insufficiency, hyperchloremic metabolic acidosis, respiratory acidosis) and in patients receiving other drugs that may cause hypokalemia (eg, loop diuretics, thiazide diuretics, laxatives, antifungals, penicillin, theophylline)

            Can cause hyperchloremic nonanion gap metabolic acidosis; coadministration with other drugs that cause metabolic acidosis may increase the severity; measure bicarbonate at baseline and then periodically; if metabolic acidosis develops or persists, consider reducing dose or discontinuing the drug

            Increased risk of falls; risk is greater in elderly patients and with higher doses

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            Pregnancy & Lactation

            Pregnancy

            Pregnancy Category: C

            Lactation

            Unknown if distributed in human breast milk

            Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

            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

            Carbonic anhydrase inhibitor, but the exact mechanism by which dichlorphenamide is able to treat periodic paralysis is unknown

            Dichlorphenamide helps to normalize blood-potassium levels by decreasing levels

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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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