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- Trimethobenzamide HCl
- Trimethobenzamide Hydrochloride
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule, Oral, as hydrochloride:
Tigan: 300 mg
Generic: 300 mg
Solution, Intramuscular, as hydrochloride:
Tigan: 100 mg/mL (2 mL)
Tigan: 100 mg/mL (20 mL) [contains phenol]
Generic: 100 mg/mL (2 mL [DSC], 20 mL [DSC])
Brand Names: U.S.
Acts centrally to inhibit the medullary chemoreceptor trigger zone by blocking emetic impulses to the vomiting center
Via oxidation, forms metabolite trimethobenzamide N-oxide
Urine (30% to 50%, as unchanged drug)
Onset of Action
Oral: 10 to 40 minutes; IM: 15 to 35 minutes
Time to Peak
Oral: ~45 minutes; IM: ~30 minutes
Duration of Action
Oral: 3 to 4 hours; IM: 2 to 3 hours
7 to 9 hours
Use: Labeled Indications
Nausea/vomiting: Treatment of postoperative nausea and vomiting; treatment of nausea associated with gastroenteritis
Hypersensitivity to trimethobenzamide or any component of the formulation; injection contraindicated in children
Nausea/vomiting: Note: Use the lowest effective dosage based on response and tolerability.
Oral: 300 mg 3 or 4 times daily
IM: 200 mg 3 or 4 times daily
Refer to adult dosing; increase the dosing interval and adjust as needed based on patient response.
Dosing: Renal Impairment
CrCl >70 mL/minute/1.73 m2: There are no dosage adjustments provided in the manufacturer's labeling.
CrCl ≤70 mL/minute/1.73 m2: Increase the dosing interval and adjust as needed based on patient response; monitor renal function closely.
Dosing: Hepatic Impairment
Avoid use in patients with hepatic impairment (due to potential risk of hepatotoxicity).
Injection: Administer IM only. Inject deep into upper outer quadrant of gluteal muscle. Not recommended for IV use.
Capsule: Administer capsule orally.
Store at 25°C (77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F).
AbobotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of AbobotulinumtoxinA. Monitor therapy
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Alcohol (Ethyl): May enhance the CNS depressant effect of Trimethobenzamide. Monitor therapy
Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Amifampridine: May diminish the anticholinergic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Amifampridine. Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol. Monitor therapy
Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Avoid combination
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy
Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Monitor therapy
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Monitor therapy
Opioid Analgesics: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Analgesics. Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Consider therapy modification
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
RimabotulinumtoxinB: Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Monitor therapy
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Frequency not defined.
Cardiovascular: Hypotension (IV administration)
Central nervous system: Coma, depression, disorientation, dizziness, drowsiness, extrapyramidal reaction, headache, opisthotonos, Parkinsonian-like symptoms, seizure
Dermatologic: Allergic skin reaction
Hematologic & oncologic: Hematologic disease
Hypersensitivity: Hypersensitivity reaction
Local: Burning sensation at injection site, erythema at injection site, pain at injection site, swelling at injection site
Neuromuscular & skeletal: Muscle cramps
Ophthalmic: Blurred vision
Concerns related to adverse effects:
• CNS effects: CNS serious adverse effects (eg, coma, mood depression, disorientation, seizure) have been reported. Consider reducing the daily dosage by increasing the dosing interval or discontinuing use if serious CNS reactions occur. May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving). Recent or concomitant use of other medications causing CNS depression or adverse events may increase the risk of serious CNS reactions.
• Extrapyramidal symptoms: May cause extrapyramidal symptoms (EPS), primarily acute dystonic reactions (ie, sudden onset of muscular spasms usually in the head/neck or opisthotonos); other EPS (akathisia, restlessness, akinesia, other parkinsonian-like symptoms [eg, tremor]), laryngospasm, dysphagia, oculogyric crisis) may also occur. If EPS occurs, reduce the daily dosage by increasing the dosing interval or discontinue therapy, depending on the severity of symptoms. Treat acute dystonic reactions with anticholinergics. Avoid use in patients receiving concomitant therapy (eg, antipsychotics) that cause EPS.
• Hepatotoxicity: Use may potentially cause hepatotoxicity. If hepatic impairment occurs during therapy, discontinue use.
• Skin reactions: Allergic-type skin reactions have been reported with use; discontinue with signs of sensitization.
• Hepatic impairment: Avoid use in patients with hepatic impairment.
• Renal impairment: Use with caution in patients with renal impairment; clearance is predominantly renal; dosage reduction recommended in patients with CrCl ≤70 mL/minute/1.73 m2.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
• Pediatric: Injection is contraindicated in children. Oral formulation is not recommended for use in pediatrics due to risk of EPS, serious CNS effects, and other potential adverse effects associated with use.
• Masking effects: EPS and other CNS effects that may result from use may mask signs of an undiagnosed primary disease (eg, encephalopathy, metabolic imbalance, Reye syndrome). If CNS symptoms occur, evaluate the risks vs. benefits of continuing therapy.
Adverse events were observed in some animal reproduction studies. Although use for the treatment of nausea and vomiting in pregnancy has been reported (Pretorius 1961), use of other agents is recommended (ACOG 2015; Arsenault 2002).
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience diarrhea, fatigue, or headache. Have patient report immediately to prescriber signs of liver problems (dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or jaundice), severe dizziness, passing out, tremors, difficulty moving, rigidity, abnormal movements, muscle spasm, muscle cramps, difficulty swallowing, difficulty speaking, agitation, change in balance, severe loss of strength and energy, blurred vision, depression, seizures, confusion, chills, pharyngitis, bruising, or bleeding (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
More about trimethobenzamide
- Side Effects
- During Pregnancy
- Dosage Information
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- Drug class: anticholinergic antiemetics
- Trimethobenzamide Hydrochloride (AHFS Monograph)
- Trimethobenzamide (FDA)
- Trimethobenzamide Capsules (FDA)
Other brands: Tigan