trimethobenzamide (Rx)

Brand and Other Names:Tigan

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsules

  • 300mg

injectable solution

  • 100mg/mL

Emesis

300 mg PO q6-8hr OR

200 mg IM q6-8hr

Renal Impairment

CrCl ≤70 mL/min/1.73 m2: Reduce dose or increase dosing interval; adjust dose as necessary based on patient response; monitor renal function closely

CrCl>70 mL/min/1.72 m2: No adjustments provided by manufacturer

Dosage Forms & Strengths

capsules

  • 300mg

Emesis

20 mg/kg/day PO divided q6-8hr

Consider lower initial dose

Emesis

300 mg PO q6-8hr OR

200 mg IM q6-8hr

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Interactions

Interaction Checker

and trimethobenzamide

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     activity indicator 
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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (3)

              • metoclopramide intranasal

                trimethobenzamide, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • olopatadine intranasal

                trimethobenzamide and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • ropeginterferon alfa 2b

                ropeginterferon alfa 2b and trimethobenzamide both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.

              Monitor Closely (5)

              • cenobamate

                cenobamate, trimethobenzamide. Either increases effects of the other by sedation. Use Caution/Monitor.

              • daridorexant

                trimethobenzamide and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • difelikefalin

                difelikefalin and trimethobenzamide both increase sedation. Use Caution/Monitor.

              • midazolam intranasal

                midazolam intranasal, trimethobenzamide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • stiripentol

                stiripentol, trimethobenzamide. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              Minor (1)

              • apomorphine

                trimethobenzamide decreases effects of apomorphine by pharmacodynamic antagonism. Minor/Significance Unknown. Trimethobenzamide may decrease the emetic response to apomorphine; monitor for additive CNS effects.

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              Adverse Effects

              Frequency Not Defined

              Dizziness

              Parkinson-like symptoms

              Sedation

              Headache

              Hypersensitivity reactions

              Irritation at injection site

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              Warnings

              Contraindications

              Hypersensitivity to drug or excipients

              Cautions

              EPS and other CNS symptoms, which can occur in patients treated with may be confused with CNS signs of undiagnosed primary disease (eg, encephalopathy, metabolic imbalance, Reye’s syndrome); if CNS symptoms occur, evaluate risks and benefits of continuing therapy

              Serious CNS adverse reactions such as coma, depression of mood, disorientation, and seizures reported; recent use of other drugs that cause CNS depression or EPS symptoms (eg, alcohol, sedatives, hypnotics, opiates, anxiolytics, antipsychotics, and anticholinergics) may also increase risk for these serious CNS reactions; consider reducing daily dosage by increasing dosing interval or discontinuing drug

              Therapy is potentially hepatotoxic; avoid use in patients whose signs and symptoms suggest presence of hepatic impairment; discontinue therapy in patients who develop impaired liver function while receiving drug

              Therapy can cause drowsiness and may impair mental and/or physical abilities needed to perform hazardous tasks (driving a motor vehicle or operating machinery); choose therapy over concomitant use of other drugs that cause CNS depression or EPS symptoms (eg, alcohol, sedatives, hypnotics, opiates, anxiolytics, antipsychotics, and anticholinergics), depending on importance of drug to patient

              Inform patients not to operate motor vehicles or other dangerous machinery until they are reasonably certain that therapy does not affect them adversely

              Extrapyramidal symptoms

              • Extrapyramidal symptoms (EPS), manifested primarily as acute dystonic reactions, may occur; dystonic reactions may include sudden onset of muscular spasms, especially in the head and neck or opisthotonos
              • Other EPS include laryngospasm, dysphagia, and oculogyric crisis; involuntary spasms of tongue and mouth may lead to difficulty in speaking and swallowing; anticholinergic drugs can be used to treat acute dystonic reactions
              • EPS may include akathisia, restlessness, akinesia, and other parkinsonian-like symptoms (eg, tremor); depending on severity of symptoms, reduce daily dosage by increasing dosing interval or discontinue therapy
              • Avoid using drug in patients receiving other drugs that are likely to cause EPS (eg, antipsychotics)
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              Pregnancy & Lactation

              Pregnancy

              Limited available data in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage

              Animal data

              • No adverse developmental effect observed in animal reproduction studies with administration of therapy during organogenesis in pregnant rats at doses 0.16 and 0.8 times the recommended human dose (RHD) and in pregnant rabbits at doses 1.6 times the RHD

              Lactation

              There is no information on presence of drug in human milk, effects of drug on breastfed infant or on milk production; lack of clinical data during lactation precludes clear determination of risk of drug to infant during lactation

              Consider developmental and health benefits of breastfeeding along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from drug or from 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

              Unclear, the drug appears to directly affect medullary chemoreceptor trigger zone by inhibiting emetic stimuli to the vomiting center

              Pharmacokinetics

              Onset: 15-35 min (IM), 10-40 min (PO)

              Duration: 2-3 hr (IM), 3-4 hr (PO)

              Bioavailability: BA of oral dose equals 60-100% of IM dose

              Half-life elimination: 7-9hr

              Metabolism: Liver

              Metabolites: N-desmethyl & N-oxide derivatives

              Excretion: Urine (30-50%), feces via bile

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              trimethobenzamide oral
              -
              300 mg capsule
              trimethobenzamide oral
              -
              300 mg capsule
              Tigan intramuscular
              -
              100 mg/mL vial
              Tigan intramuscular
              -
              100 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

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              Patient Education
              trimethobenzamide oral

              TRIMETHOBENZAMIDE - ORAL

              (trye-METH-oh-BEN-za-mide)

              COMMON BRAND NAME(S): Tigan

              USES: Trimethobenzamide is used to treat nausea and vomiting that may occur after surgery or with a certain stomach/intestinal problem (gastroenteritis). Treating vomiting quickly can prevent dehydration.This medication is not recommended for use in children due to risk of serious side effects.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually 3 to 4 times a day.The dosage is based on your medical condition, age, and response to treatment. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Diarrhea, headache, dizziness, drowsiness, or blurred vision may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.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: mental/mood changes (such as depression, confusion, restlessness), yellowing eyes/skin, dark urine, muscle spasms, unusual uncontrolled movements (especially of the face, mouth, tongue, arms, or legs), severe arching of the back, shaking (tremor).Get medical help right away if you have any very serious side effects, including: 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 trimethobenzamide, 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: liver disease, kidney problems, stomach/intestinal problems (such as appendicitis), swelling/disease of the brain (encephalitis/encephalopathy), dehydration, electrolytes imbalance.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. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially unusual uncontrolled movements and shaking.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug 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.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. 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.

              NOTES: Do not share this medication with others.

              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 August 2021. Copyright(c) 2023 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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              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.
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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.