Management of symptoms of pheochromocytoma (particularly hypertension and sweating) caused by adrenergic (sympathomimetic) excess.
Treatment of hypertension associated with adrenergic excess, including that produced by tyramine-containing foods in patients receiving MAO inhibitor therapy.
PO (Adults ): 10 mg twice daily; ↑ by 10 mg/day at 2-day intervals. Usual maintenance dose is 20–40 mg 2–3 times daily.
PO (Children ): 0.2 mg/kg or 6 mg/m2 daily (not to exceed 10 mg); dosage increments may be made at 4-day intervals. Usual maintenance dose is 0.4–1.2 mg/kg/day (12–36 mg/m2/day) in 3–4 divided doses.
Metabolism/Excretion: Mostly metabolized by the liver.
Half-Life: 24 hr.
Time/Action Profile⬆⬇
(alpha-adrenergic blockade)
ROUTE
ONSET
PEAK
DURATION
PO
1–4 hr
1 wk
3–4 days
Patient/Family Teaching⬆⬇
Instruct patient to take medication exactly as directed at the same time each day. Do not skip or double up on missed doses. Consult health care professional before discontinuation.
Medication may cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Caution patient to make position changes slowly to minimize orthostatic hypotension. Standing for long periods or exercising during hot weather may also induce orthostatic hypotension.
Inform patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may reduce dryness of mouth. Health care professional should be notified if dryness persists >2 wk. Regular dental care is recommended; dry mouth may increase risk of caries and periodontal disease.
Advise patient to avoid use of alcohol or OTC cold preparations without consulting health care professional.
Inform patient that medication may cause nasal congestion, inhibition of ejaculation, and constriction of pupils, which may interfere with night vision. These effects usually decrease with continued therapy. Notify health care professional if these side effects persist.
Advise patient to inform health care professional of medication regimen before treatment or surgery.
