Metaraminol

[1 vial $6.01]

ADMINISTRATION ROUTES

• IV

ALTERNATIVE NAMES

• Aramine

ICU INDICATIONS

1. hypotension (particularly during induction of anaesthesia)

PRESENTATION AND ADMINISTRATION

• IV:
  10mg in 1ml vial
  Dilute 10mg in 20ml of compatible IV fluid (i.e. make up to a concentration of 0.5mg/ml)
  Compatible with the following IV fluids:
  Sodium Chloride, 5% dextrose, Hartmanns
  Store at room temperatureNote: metaraminol is a section 29 medicine

DOSAGE:

• IV: 0.5-1mg PRN

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY

• Dose as in normal renal function

DOSAGE IN PAEDIATRICS

• IV:
  0.01mg/kg PRN

CLINICAL PHARMACOLOGY

• Metaraminol is a potent sympathomimetic amine that increases both systolic and diastolic blood pressure.

CONTRAINDICATIONS

1. hypersensitivity to metaraminol

WARNINGS

• Metaraminol contains sodium bisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people.

PRECAUTIONS

• General:
  Caution should be used to avoid excessive blood pressure response. Rapidly induced hypertensive responses have been reported to cause acute pulmonary oedema, arrhythmias, cerebral haemorrhage, or cardiac arrest.
  Because of its vasoconstrictor effect metaraminol should be given with caution in heart or thyroid disease, hypertension, or diabetes.
• Laboratory Tests:
  No tests in addition to routine ICU tests are required.
• Drug/Laboratory Test Interactions:
  None noted.

IMPORTANT DRUG INTERACTIONS FOR THE ICU

• Metaraminol should be used with caution in digitalized patients, since the combination of digitalis and sympathomimetic amines may cause ectopic arrhythmias. Monoamine oxidase inhibitors or tricyclic antidepressants may potentiate the action of sympathomimetic amines. Therefore, when initiating pressor therapy in patients receiving these drugs, the initial dose should be small and given with caution.

ADVERSE REACTIONS

• Most adverse effects seen arise due to inadvertent excess dosing.
• Cardiovascular:
  Hypertension, tachycardia, bradycardia, pulmonary oedema, atrial or ventricular arrhythmia.
• Central nervous system:
  Cerebral hemorrhage, convulsions.