trimethobenzamide (Rx)

Brand and Other Names:Tigan
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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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            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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            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.