Alimemazine


Generic Medicine Info
Indications and Dosage
Oral
Premedication in surgery
Child: 2-7 yr Up to 2 mg/kg 1-2 hr prior to the procedure.

Oral
Pruritic skin disorders, Urticaria
Adult: As alimemazine tartrate: 10 mg 2 or 3 times daily. Refractory cases: Up to 100 mg daily.
Child: >2 yr As alimemazine tartrate: 2.5-5 mg 3 or 4 times daily.
Elderly: As alimemazine tartrate: 10 mg 1 or 2 times daily.
Renal Impairment
Contraindicated.
Hepatic Impairment
Contraindicated.
Administration
May be taken with or without food.
Contraindications
Epilepsy, parkinsonism, hypothyroidism, phaechromocytoma, myasthenia gravis, prostatic hypertrophy, history of narrow angle glaucoma. Renal and hepatic impairment. Childn <2 yr. Lactation.
Special Precautions
Patient w/ volume depletion, CV disease, chronic constipation, pyloroduodenal obstruction, urinary retention, history of seizure. Childn and elderly. Pregnancy.
Adverse Reactions
Nasal stuffiness, dry mouth, insomnia, agitation, convulsion; jaundice; hypotension, pallor; AV block, ventricular tachycardia and fibrillation; ECG changes; mild leucopenia, unexplained fever/infection; acute dystonia/dyskinesia, akathisia, parkinsonism, tremor, rigidity, akinesia, tardive dyskinesia; skin rashes, photosensitivity, ocular changes, metallic greyish-mauve colouration of skin; hyperprolactinaemia (i.e. galactorrhoea, gynaecomastia, amenorrhoea, impotence); neuroleptic malignant syndrome (i.e. hyperthermia, autonomic dysfunction, altered consciousness); paradoxical excitement. Rarely, agranulocytosis, contact skin sensitisation.
Patient Counseling Information
Avoid alcohol intake and exposure to sunlight. This drug may cause drowsiness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor vital signs and mental status.
Overdosage
Symptoms: Drowsiness, loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmia, hypothermia, severe extrapyramidal dyskinesia, generalised vasodilation, circulatory collapse, neuroleptic malignant syndrome (NMS) (i.e. hyperthermia, muscle rigidity, altered mental status, autonomic instability). Management: Supportive treatment. Employ gastric lavage or activated charcoal. Pronounced CNS depression may require airway maintenance or assisted respiration (in extreme cases). Treat generalised vasodilation w/ warmed IV infusion fluids and by raising patient’s legs. Treat severe dystonic reactions w/ 5-10 mg of procyclidine or 20-40 mg of orphenadrine via IV/IM inj. Treat convulsions w/ IV diazepam. Treat NMS by cooling or w/ dantrolene Na.
Drug Interactions
Intensified sedative effect w/ anxiolytics, hypnotics, opiates, barbiturates, and other sedatives. Interfered absorption w/ antacids, antiparkinson agents, and lithium. May exaggerate the hypotensive effects of antihypertensive drugs esp α-adrenoreceptor blockers. May increase side effects of antimuscarinics. May oppose actions of amphetamine, levodopa, clonidine, guanethidine, and epinephrine. May reduce the response to hypoglycaemic agents.
Food Interaction
Absorption is delayed by food. Intensified sedative effect w/ alcohol.
Action
Description: Alimemazine, a phenothiazine derivative, is an antihistamine w/ marked sedative and antiemetic effects. Additionally, it has antispasmodic, antiserotonin, and weak antimuscarinic properties.
Pharmacokinetics:
Absorption: Delayed by food. Bioavailability: <70%.
Distribution: Plasma protein binding: >90%.
Chemical Structure

Chemical Structure Image
Alimemazine

Source: National Center for Biotechnology Information. PubChem Database. Trimeprazine, CID=5574, https://pubchem.ncbi.nlm.nih.gov/compound/Trimeprazine (accessed on Jan. 20, 2020)

Storage
Store below 25°C. Protect from light.
MIMS Class
Antihistamines & Antiallergics
ATC Classification
R06AD01 - alimemazine ; Belongs to the class of phenothiazine derivatives used as systemic antihistamines.
References
Anon. Trimeprazine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/08/2016.

Buckingham R (ed). Alimemazine Tartrate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/08/2016.

Joint Formulary Committee. Alimemazine Tartrate (Trimeprazine Tartrate). British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/08/2016.

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