tromethamine

Generic Name: tromethamine (troe METH a meen)
Brand Name: Tham

What is tromethamine?

Tromethamine affects the balance of water and electrolytes in the body.

Tromethamine is used to treat metabolic acidosis (an electrolyte imbalance). Metabolic acidosis can have many causes. It often occurs after heart bypass surgery or cardiac arrest.

Tromethamine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about tromethamine?

You should not receive this medication if you have uremia (urea circulating in your blood), or if you are unable to urinate (such as due to kidney failure).

Before receiving tromethamine, tell your doctor if you are allergic to any drugs, or if you have asthma, kidney disease, or congestive heart failure.

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Tell your caregivers right away if you have any swelling or rapid weight gain, shortness of breath, weak or shallow breathing, swelling or skin changes where the medicine was injected, fast heart rate, or feeling like you might pass out.

What should I discuss with my health care provider before receiving tromethamine?

You should not receive this medication if you have uremia (urea circulating in your blood) or if you are unable to urinate (such as due to kidney failure).

If possible, before you receive tromethamine, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;

  • congestive heart failure; or

  • asthma or other breathing problems.

If you have any of these conditions, you may not be able to receive tromethamine, or you may need dosage adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether tromethamine passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before you are treated with tromethamine to tell your caregivers about any health conditions you have or if you are pregnant or breast-feeding. However, make sure any doctor caring for your pregnancy or your baby knows that you have received this medication.

How is tromethamine given?

Tromethamine is given as an injection under the skin or into a muscle. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion.

Tromethamine is often given for only a short period of time, such as one day. The length of time you receive treatment will depend on how your body responds to the medication.

To be sure this medication is not causing harmful effects, your blood and heart function will need to be checked throughout your treatment.

After treatment with tromethamine, you will be closely watched and tested to make sure the medication has been effective and you no longer have any effects of metabolic acidosis.

What happens if I miss a dose?

Since tromethamine is usually given as needed in a hospital setting, it is not likely that you will miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include fast heart rate, rapid weight gain, trouble breathing; confusion, sweating, or seizure (convulsions).

What should I avoid after receiving tromethamine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity after your treatment with tromethamine.

Tromethamine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have any of these serious side effects:

  • swelling, rapid weight gain, feeling short of breath;

  • weak or shallow breathing;

  • pain, swelling, or skin changes where the medicine was injected;

  • fast heart rate; or

  • feeling like you might pass out.

Less serious side effects may include:

  • hunger, weakness;

  • confusion, irritability;

  • drowsiness, dizziness, tremors;

  • headache, weakness; or

  • increased sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Tromethamine dosing information

Usual Adult Dose for Metabolic Acidosis:

Associated with Cardiac Bypass Surgery:
Initial dose: 500 mL (150 mEq) by slow intravenous infusion is considered adequate for most adults; up to 1000 mL may be required in severe cases
Maximum dose: 500 mg/kg (227 mg/lb) over a period of not less than one hour

Associated with Cardiac Arrest:
If the chest is open: 2 to 6 g (62 to 185 mL of a 0.3 M solution) injected into the ventricular cavity
If the chest is not open: 3.6 to 10.8 g (111 to 333 mL of a 0.3 M solution) injected into a larger peripheral vein if the chest is not open
Comment: Do not inject into the cardiac muscle

Usual Pediatric Dose for Metabolic Acidosis:

Associated with RDS in Neonates and Infants:
1 mL/kg for each pH unit below 7.4

What other drugs will affect tromethamine?

Before receiving tromethamine, tell your doctor if you have recently used any type of medication that can slow your breathing, such as a narcotic pain reliever.

This list is not complete and there may be other drugs that can interact with tromethamine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about tromethamine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.04. Revision Date: 2010-12-15, 5:01:39 PM.

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