TRIMEPRAZINE TARTRATE, TRIMEPRAZINE TARTRATE WITH PREDNISOLONE
Chemistry - A phenothiazine antihistamine related to promethazine, trimeprazine tartrate occurs asan odorless, white, to off-white crystalline powder with a melting range of 160-164°C.
Approximately 0.5 gm is soluble in 1 ml water, and 0.05 gm is soluble in 1 ml of alcohol.
Trimeprazine may also be known as alimenazine tartrate.
The veterinary-approved product also has prednisolone in its formulation which provides additionalanti-inflammatory effects.
Uses, Indications - Trimeprazine is used alone for the treatment of pruritic conditions, especially ifinduced by allergic conditions. The veterinary combination product is suggested (by the manufacturer) to be used in dogs for either pruritic conditions or as an antitussive.
Contraindications/Precautions - The contraindications and precautions of this product followthose of the other phenothiazines and antihistaminic agents. For more information it is suggested toreview the acepromazine, and chlorpheniramine monographs. The manufacturer of the veterinarycombination product (Temaril®-P) warns that corticosteroids can induce the first stages ofparturition if administered during the last trimester of pregnancy.
Additional adverse effects, if using the product containing steroids include: elevated liver enzymes, weight loss, polyuria/polydypsia, vomiting and diarrhea. If used chronically, therapy must bewithdrawn gradually and Cushing's Syndrome may develop.
The manufacturer of the veterinary combination product (Temaril®-P) includes the followingadverse effects in its package insert: sodium retention and potassium loss, negative nitrogen balance, suppressed adrenocortical function, delayed wound healing, osteoporosis, possible increasedsusceptibility to and/or exacerbation of bacterial infections, sedation, protruding nictitatingmembrane, blood dyscrasias. Also, intensification and prolongation of the action of sedatives, analgesics or anesthetics can be noted and potentiation of organophosphate toxicity and of procaine
HCl activity.
Overdosage - Acute overdosage should be handled as per the acepromazine monograph found atthe beginning of the book..
Quinidine when given with phenothiazines may cause additive cardiac depression.
Antidiarrheal mixtures (e.g., Kaolin/pectin, bismuth subsalicylate mixtures) and antacids maycause reduced GI absorption of oral phenothiazines. Increased blood levels of both drugs mayresult if propranolol is administered with phenothiazines.
Phenothiazines block alpha-adrenergic receptors; if epinephrine is also given, unopposed betaactivity causing vasodilation and increased cardiac rate can occur. Phenytoin metabolism may bedecreased if given concurrently with phenothiazines.
If using the product containing prednisolone, the following interactions may also occur:
Amphotericin B or potassium-depleting diuretics (furosemide, thiazides) when administeredconcomitantly with steroids may lead to hypokalemia. Steroids may reduce salicylate blood levels.
Insulin requirements may increase in patients taking glucocorticoids. Phenytoin or phenobarbital may increase the metabolism of glucocorticoids.
Laboratory Interactions - Antihistamines can decrease the wheal and flare response to antigenskin testing. In humans, it is suggested that antihistamines be discontinued at least 4 days beforetesting. Glucocorticoids may increase urine glucose levels and decrease T3 & T4 values.
Approximately 0.5 gm is soluble in 1 ml water, and 0.05 gm is soluble in 1 ml of alcohol.
Trimeprazine may also be known as alimenazine tartrate.
Storage, Stability, Compatibility
Store trimeprazine products at room temperature (15-30°C);avoid freezing the oral solution. Tablets and capsules should be kept in well-closed containers andthe oral solution should be kept in tight containers. Protect the oral solution and tablets from light.Pharmacology - TRIMEPRAZINE TARTRATE, TRIMEPRAZINE TARTRATE WITH PREDNISOLONE
Trimeprazine has antihistaminic, sedative, antitussive and antipruritic qualities.The veterinary-approved product also has prednisolone in its formulation which provides additionalanti-inflammatory effects.
Uses, Indications - Trimeprazine is used alone for the treatment of pruritic conditions, especially ifinduced by allergic conditions. The veterinary combination product is suggested (by the manufacturer) to be used in dogs for either pruritic conditions or as an antitussive.
Pharmacokinetics - TRIMEPRAZINE TARTRATE, TRIMEPRAZINE TARTRATE WITH PREDNISOLONE
The pharmacokinetics of trimeprazine have apparently not been studied.Contraindications/Precautions - The contraindications and precautions of this product followthose of the other phenothiazines and antihistaminic agents. For more information it is suggested toreview the acepromazine, and chlorpheniramine monographs. The manufacturer of the veterinarycombination product (Temaril®-P) warns that corticosteroids can induce the first stages ofparturition if administered during the last trimester of pregnancy.
Adverse Effects, Warnings
For trimeprazine, possible adverse reactions include: sedation, depression, hypotension and extrapyrimidal reactions (rigidity, tremors, weakness, restlessness, etc.).Additional adverse effects, if using the product containing steroids include: elevated liver enzymes, weight loss, polyuria/polydypsia, vomiting and diarrhea. If used chronically, therapy must bewithdrawn gradually and Cushing's Syndrome may develop.
The manufacturer of the veterinary combination product (Temaril®-P) includes the followingadverse effects in its package insert: sodium retention and potassium loss, negative nitrogen balance, suppressed adrenocortical function, delayed wound healing, osteoporosis, possible increasedsusceptibility to and/or exacerbation of bacterial infections, sedation, protruding nictitatingmembrane, blood dyscrasias. Also, intensification and prolongation of the action of sedatives, analgesics or anesthetics can be noted and potentiation of organophosphate toxicity and of procaine
HCl activity.
Overdosage - Acute overdosage should be handled as per the acepromazine monograph found atthe beginning of the book..
Drug Interactions
Other CNS depressant agents (barbiturates, narcotics, anesthetics, etc.) may cause additive CNS depression if used with phenothiazines.Quinidine when given with phenothiazines may cause additive cardiac depression.
Antidiarrheal mixtures (e.g., Kaolin/pectin, bismuth subsalicylate mixtures) and antacids maycause reduced GI absorption of oral phenothiazines. Increased blood levels of both drugs mayresult if propranolol is administered with phenothiazines.
Phenothiazines block alpha-adrenergic receptors; if epinephrine is also given, unopposed betaactivity causing vasodilation and increased cardiac rate can occur. Phenytoin metabolism may bedecreased if given concurrently with phenothiazines.
If using the product containing prednisolone, the following interactions may also occur:
Amphotericin B or potassium-depleting diuretics (furosemide, thiazides) when administeredconcomitantly with steroids may lead to hypokalemia. Steroids may reduce salicylate blood levels.
Insulin requirements may increase in patients taking glucocorticoids. Phenytoin or phenobarbital may increase the metabolism of glucocorticoids.
Laboratory Interactions - Antihistamines can decrease the wheal and flare response to antigenskin testing. In humans, it is suggested that antihistamines be discontinued at least 4 days beforetesting. Glucocorticoids may increase urine glucose levels and decrease T3 & T4 values.