Metaraminol tartrate parenteral
- Drugs List
- Therapeutic Indications
- Dosage
- Administration
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Parenteral formulation of metaraminol tartrate.
Drugs List
Therapeutic Indications
Uses
Hypotension - acute
Treatment of acute hypotension due to loss of vasoconstrictor tone as may occur during spinal anaesthesia and as an adjunct to accepted remedial procedures.
Unlicensed Uses
Priapism
Treatment of priapism.
Dosage
Adults
Direct intravenous injection in grave emergencies
500micrograms to 5mg, then followed by an infusion of 15mg to 100mg in 500ml of infusion liquid.
Particular care should be taken to use the correct dose when injecting undiluted metaraminol.
Intravenous infusion
15mg to 100mg in 500ml sodium chloride injection or dextrose 5% injection, adjusting the rate of infusion to maintain the blood pressure at the desired level.
Higher concentrations of metaraminol have been used when appropriate to the circumstances.
Priapism (unlicensed)
Intracavernosal injection
1mg diluted to 50ml with sodium chloride injection 0.9%.
Given carefully by slow injection into the corpora in 5ml injections every 15 minutes.
Children
Children aged 12 years and older:(See Dosage; Adult)
Administration
For intravenous injection and infusion.
Unlicensed use for intracavernosal injections.
Contraindications
Children under 12 years
Within 2 weeks of discontinuing MAOIs
Hypovolaemia
Precautions and Warnings
Elderly
Asthma
Breastfeeding
Cardiac disorder
Diabetes mellitus
Hepatic cirrhosis
History of malaria
Hypercapnia
Hypertension
Hyperthyroidism
Hypoxia
Myocardial infarction
Pregnancy
Prinzmetal's angina
Thromboembolic disorder
Some brands contain metabisulfite, may cause bronchospasm/allergies
Avoid contact of product with skin
If extravasation occurs follow local policy & seek expert help immediately
Monitor blood pressure
Avoid abrupt withdrawal
Discontinue infusion if infiltration of thrombosis occurs
Use in conjunction with appropriate blood volume replacement
Caution should be exercised to avoid excessive blood pressure changes since response to treatment with metaraminol is very variable and the ensuing control of the blood pressure may prove difficult.
An excessive vasopressor response may cause a prolonged elevation of blood pressure, even after discontinuation.
Metaraminol should be used with caution in patients with cirrhosis; electrolyte levels should be adequately restored if diuresis ensues.
Sympathomimetic amines may provoke a relapse in patients with a history of malaria.
In patients with peripheral vascular disease, diabetes mellitus, Buerger's disease or conditions with coexistent hypercoagulability, larger veins of the antecubital fossa or thigh are preferred as an injection site.
If blanching occurs, consider changing the site of infusion to allow vasoconstriction to subside.
Pregnancy and Lactation
Pregnancy
Use metaraminol with caution during pregnancy.
The manufacturer advises metaraminol is only used during pregnancy if the potential benefits outweigh the risk. At the time of writing there is limited published information regarding the use of metaraminol during pregnancy. Potential risks are unknown.
Lactation
Use metaraminol with caution during breastfeeding.
The manufacturer advises caution if metaraminol is used when breastfeeding. The presence of metaraminol in human breast milk and the effects on exposed infants are unknown.
Side Effects
Abscess
Arrhythmias
Bradycardia
Headache
Hypertension
Ischaemia
Nausea
Necrosis (injection site)
Palpitations
Sloughing of tissue
Tachycardia
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: June 2021
Reference Sources
Summary of Product Characteristics: Metaraminol 10mg/ml solution for injection/infusion. Flexipharm Austrading Limited. Revised March 2021.
Summary of Product Characteristics: Metaraminol 0.5mg/ml solution for injection/infusion. Flexipharm Austrading Limited. Revised March 2021.
Summary of Product Characteristics: Metaraminol 10mg/ml solution for injection or infusion. Torbay Pharmaceuticals, South Devon Healthcare NHS Foundation trust. Revised June 2016.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 10 August 2021
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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