METHOTRIMEPRAZINE (NOZINAN): Uses in Palliative Care
METHOTRIMEPRAZINE is a neuroleptic agent that has analgesic, anti-emetic, antihistamine, antiadrenergic and sedative activity.
USE of METHOTRIMEPRAZINE:
- Licensed Use: For sedation, end of life delirium, restlessness or agitation and as an adjunct to analgesia when some sedation may be desirable or beneficial to the patient.
- Unlicensed Use: Nausea and vomiting. When first line medications have proven less than effective, methotrimeprazine has a broad action.
CARE CONSIDERATIONS will depend on goals of care and indication of use:
- Watch for excessive drowsiness
- Monitor for postural hypotension
- Inflammatory reactions at injection site
- The injectable preparation contains sodium sulfite which may cause an allergic reaction
DOSAGE:
- For Mild Delirium: 5-12.5 mg PO or s/c q12hr AND 5-12.5 mg PO or s/c q1hr PRN
- For Moderate Delirium: 12.5 mg PO or s/c q 8- 12hr AND 12.5 mg PO or s/c q1hr PRN
- For Severe Delirium: 25 mg s/c stat and may be repeated q30 minutes up to 3-4 times
- For Nausea & Vomiting: 2-5 g PO or s/c BID or TID and titrating up to a maximum of 12.5 mg s/c or PO
- Doses may vary according to guideline used
Source: – Pereira JL, Associates. The Pallium Palliative Pocketbook: a peer-reviewed, referenced resource. 1st Cdn ed. Edmonton, Canada: Pallium Canada; 2008. 3 rd Printing 2013 – Palliative Care Formulary, Canadian Edition, 2010
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