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PANECTYL is a brand name for Trimeprazine (also known as Alimemazine), supplied as a tablet. The medicine, its uses, side effects and dosage are the same regardless of brand.
Verbatim from this product's HC label. Tap a section to expand.
States of CNS depression due to barbiturates, alcohol, narcotics or analgesics. Cases with a history of blood dyscrasias or severe allergic reactions related to trimeprazine or other phenothiazines. Trimeprazine is contraindicated for use in children less than two years of age.
(see Warnings section). WARNINGS Patients should be advised against driving or engaging in activities requiring complete mental alertness or physical co-ordination, until their response to the drug has been well established. Use in pregnant women is not recommended except when, in the judgement of the physician, it is necessary for the welfare of the patient.
Trimeprazine is contraindicated for use in children less than two years of age due to the risk of marked sedation and respiratory depression. Cardiac arrhythmias and ECG abnormalities Atrioventricular (AV) block, supraventricular tachycardia, ventricular tachycardia and fibrillation have been reported during therapy, possibly related to dosage.
Pre-existing cardiac disease, old age, hypokalaemia and concurrent tricyclic antidepressants may predispose to PANECTYL- induced cardiac arrhythmias. Electrocardiograph (ECG) changes, usually benign, include prolongation of the QT interval, ST depression, U-waves and T-wave changes.
Very rare cases of Torsade de Pointes, ventricular fibrillation, cardiac arrest and sudden death have been observed (see ADVERSE REACTIONS). Some of these events were only observed post- marketing. PRECAUTIONS Panectyl should be used with caution when there is a risk of potentiating CNS depressant drugs such as opiates, analgesics, antihistaminics, barbiturates and alcohol.
It should also be used with caution in patients with a history of convulsive disorders or liver disease, and in cases of jaundice. Since phenothiazines are known to reverse the pressor effect of epinephrine, if hypotension should occur, epinephrine should not be used as it may depress further the blood pressure.
The drug should be used cautiously in severely ill or dehydrated children who are more susceptible to seizures associated with phenothiazines. 4 The antiemetic action of Panectyl may obscure signs of intestinal obstruction or brain tumor.
Ingestion after meals prolongs absorption of the drug, thus reducing incidence of possible side effects. ADVERSE REACTIONS At recommended therapeutic dosages, Panectyl is usually well tolerated.
Side effects that are likely to occur may be listed as follows :
Cardiac arrhythmias and ECG abnormalities Atrioventricular (AV) block, supraventricular tachycardia, ventricular tachycardia and fibrillation have been reported during therapy, possibly related to dosage. Pre-existing cardiac disease, old age, hypokalaemia and concurrent tricyclic antidepressants may predispose to PANECTYL- induced cardiac arrhythmias.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Electrocardiograph (ECG) changes, usually benign, include prolongation of the QT interval, ST depression, U-waves and T-wave changes. Very rare cases of Torsade de Pointes, ventricular fibrillation, cardiac arrest and sudden death have been observed.
Some of these events were only observed post-marketing. Central nervous system Drowsiness is the most common initial untoward reaction but tends to subside within one to three weeks. It occurs most frequently in older age groups, and often with daily doses of 30 mg or more.
Its incidence and intensity can be minimized by starting at a low dosage, gradually increased, or by prescribing the drug after food to promote a more gradual absorption. Should drowsiness persist it can be alleviated by decreasing dosage.
Convulsions have been reported. Extrapyramidal symptoms such as tremor, spasticity, painful contractions of skeletal muscles, dystonias have rarely been noted. Acute dystonias or dyskinaesias, usually transitory, are more common in children and young adults and usually occur within the first 4 days of treatment or after dosage increases.
Akathisia characteristically occurs after large doses. Parkinsonism is more common in adults and the elderly. It usually develops after weeks or months of treatment. One or more of the following may be seen: tremor, rigidity, akinaesia or other features of Parkinsonism.
Commonly, just tremor is seen. The occurrence of tardive dyskinaesia, if it occurs, is usually, but not necessarily, after prolonged or high dosage. It can occur after treatment has been stopped. If a neuromuscular reaction occurs, medication should be stopped and not reinstituted in children or in pregnant patients, while in others it may be resumed later, at a lower dosage.
After 5 discontinuation of treatment, extrapyramidal symptoms usually subside gradually within 24 to 48 hours. If a counteractant is necessary, barbiturates or an antiparkinsonian agent may bring rapid relief. Other infrequent side effects reported include disturbing dreams, elation, depression, and fainting.
Autonomic nervous system Dryness of mouth and nasal congestion are rare. Gastrointestinal system Gastric upset, abdominal discomfort and nausea may occur but usually disappear after a few days of medication. A few cases of cholestatic jaundice have been reported.
Skin Drug rash and dermatitis have been observed in very few patients. Allergic or Toxic Very rare cases of reversible agranulcytosis and leukopenia have been reported. This reaction has responded to immediate withdrawal of trimeprazine and administration of antibiotics and corticosteroids.
Since most reported cases of agranulocytosis, associated with the administration of phenothiazines, have occurred within the first ten weeks of treatment, patients on prolonged therapy should be observed for this reaction particularly during that period.
SYMPTOMS AND TREATMENT OF OVERDOSAGE Symptoms Drowsiness, dizziness, dryness of mucous membranes and gastrointestinal upsets. Massive overdosage may result in oversedation, collapse and coma. Neuroleptic malignant syndrome (NMS) has been reported in the context of Trimeprazine overdose.
Symptoms of NMS […]