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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 and 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
Oral: 300 mg 3 or 4 times daily
IM: 200 mg 3 or 4 times daily
According to the manufacturer, consider dosage reduction or increasing the dosing interval in elderly patients with renal impairment.
Dosing: Renal Impairment
CrCl ≤70 mL/minute/1.73 m2: Although no specific dosage adjustment provided in the manufacturer’s labeling, dosage reduction or increasing the dosing interval is recommended.
Dosing: Hepatic Impairment
No dosage adjustment provided in the manufacturer’s labeling.
Injection: Administer IM only. Inject deep into upper outer quadrant of gluteal muscle. Not recommended for IV use.
Capsule: Administer capsule orally.
Capsules and injection: Store at room temperature of 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: Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Acetylcholinesterase Inhibitors may diminish the therapeutic effect of Anticholinergic Agents. 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
Analgesics (Opioid): Anticholinergic Agents may enhance the adverse/toxic effect of Analgesics (Opioid). Specifically, the risk for constipation and urinary retention may be increased with this combination. 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. Avoid combination
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. 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
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 using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to 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, EPS, headache, Parkinson-like symptoms, seizure
Dermatologic: Allergic-type skin reactions
Hematologic: Blood dyscrasias
Local: Injection site burning, pain, redness, stinging, or swelling
Neuromuscular & skeletal: Muscle cramps, opisthotonos
Ocular: Blurred vision
Miscellaneous: Hypersensitivity reactions
Concerns related to adverse effects:
• CNS effects: The risk of CNS adverse effects (eg, coma, EPS, seizure) may be increased in patients with acute febrile illness, dehydration, electrolyte imbalance, encephalitis, and gastroenteritis; use with caution. 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).
• Extrapyramidal symptoms: May cause extrapyramidal symptoms (EPS) which may be confused with CNS symptoms of primary disease responsible for emesis.
• Skin reactions: Allergic-type skin reactions have been reported with use; discontinue with signs of sensitization.
• Renal impairment: Trimethobenzamide clearance is predominantly renal; consider dosage reductions in patients with renal impairment.
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.
• Sedatives: Effects may be potentiated when used with other sedative drugs or ethanol.
• Pediatric: Use capsule formulation with caution in children; antiemetics are not recommended for uncomplicated vomiting in children, limit antiemetic use to prolonged vomiting of known etiology. Use of injection is contraindicated in children.
• Masking effects: May mask toxicity of other drugs or conditions (eg, appendicitis, Reye syndrome, or other encephalopathy) due to antiemetic effects.
Renal function (at baseline)
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, headache, muscle cramps, or injection site pain, edema, or irritation. Have patient report immediately to prescriber severe dizziness, passing out, tremors, difficulty moving, rigidity, abnormal movements, change in balance, severe loss of strength and energy, blurred vision, depression, seizures, confusion, chills, pharyngitis, bruising, bleeding, or jaundice (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
- Trimethobenzamide Hydrochloride (AHFS Monograph)
- Trimethobenzamide (FDA)
- Trimethobenzamide Capsules (FDA)
- Other brands: Tigan