Indications for: DEMSER

Treatment of pheochromocytoma for: preoperative preparation for surgery; or management when surgery is contraindicated. Chronic treatment in malignant pheochromocytoma.

Adult Dosage:

Initially 250mg 4 times daily; may increase by 250–500mg daily up to max 4g/day in divided doses. Usual dose: 2–3g/day; monitor. If hypertensive, titrate dose to normalize BP and control symptoms; if normotensive, titrate dose to reduce urinary metanephrines and/or vanillylmandelic acid by ≥50%. Add an α-blocker (eg, phenoxybenzamine) if patients not adequately controlled. Pre-op prep: treat for at least 5–7 days.

Children Dosage:

Not recommended.

DEMSER Warnings/Precautions:

Renal or hepatic impairment. Maintain adequate hydration; if crystalluria occurs, increase more fluids; if crystalluria persists, reduce dose or discontinue. Pre-op use: maintain adequate intravascular volume intra- and postoperatively. Pregnancy (Cat.C). Nursing mothers.

DEMSER Classification:

Tyrosine hydroxylase inhibitor.

DEMSER Interactions:

Increased CNS effects with alcohol, other CNS depressants (eg, hypnotics, sedatives, tranquilizers). Potentiates extrapyramidal effects of phenothiazines, haloperidol.

Adverse Reactions:

Sedation, diarrhea, extrapyramidal effects, anxiety, CNS disturbances, crystalluria; rare: hematological disorders.

How Supplied: