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metyroSINE
Metyrosine, sold under the brand name Demser, is an antihypertensive medication primarily used to manage pheochromocytoma, a rare tumor of the adrenal glands that causes excessive production of catecholamines (stress hormones like adrenaline and noradrenaline). These hormones can lead to severe hypertension (high blood pressure) and other symptoms. Metyrosine works by inhibiting the enzyme tyrosine hydroxylase, which is involved in the production of catecholamines, reducing their levels in the body and helping to control symptoms. It is often used as part of preoperative preparation for patients undergoing surgery to remove pheochromocytomas or for long-term management of inoperable tumors.
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Frequently Asked Questions
How long does it take for metyrosine to work?
Metyrosine begins to reduce catecholamine levels within a few days of starting treatment, but full effects may take 1 to 2 weeks. Blood pressure and symptoms should be closely monitored during this period.
Can metyrosine cure pheochromocytoma?
Metyrosine does not cure pheochromocytoma. It is used to manage the symptoms and catecholamine levels associated with the tumor, particularly before surgery or in patients who cannot undergo surgery.
What should I do if I miss a dose of metyrosine?
If you miss a dose, take it as soon as you remember unless it is close to your next dose. Do not double up on doses to make up for the missed one. Follow your doctor’s instructions closely.
Can metyrosine be taken long-term?
Metyrosine can be used long-term in patients with inoperable pheochromocytoma to control symptoms. Regular monitoring is required to adjust the dosage and manage side effects.
Is it safe to take metyrosine with other blood pressure medications?
Metyrosine can be used alongside other antihypertensive medications, but blood pressure should be monitored closely to avoid excessive drops. Always inform your doctor about all medications you are taking.
Comprehensive Drug Guide
How Does metyroSINE Work?
Metyrosine works by inhibiting tyrosine hydroxylase, the enzyme responsible for converting tyrosine into catecholamines such as dopamine, norepinephrine, and epinephrine. By reducing the production of these stress hormones, metyrosine helps control the symptoms of pheochromocytoma, including high blood pressure, rapid heart rate, and anxiety. This reduction in catecholamines decreases the excessive stimulation of the cardiovascular system, providing symptom relief.
Common Dosages
- 250 mg oral capsules
The typical dosing ranges from 250 mg to 4000 mg daily, divided into multiple doses throughout the day.
Typical Dosing
- For pheochromocytoma: The initial dose is usually 250 mg four times daily, gradually increasing to a total of 2 to 4 grams per day, depending on the patient’s response and the severity of symptoms.
- The dosage is typically adjusted based on catecholamine levels and blood pressure monitoring.
Typical Dosing
FDA Approved Indications
- Pheochromocytoma: Used to control symptoms and reduce catecholamine levels before surgery or for long-term management in patients with inoperable tumors.
- Hypertensive crises associated with pheochromocytoma.
Who Shouldn't Take metyroSINE?
- Known hypersensitivity to metyrosine or any of its components
- Use with caution in patients with liver or kidney impairment, as it can affect the metabolism and clearance of the drug.
Advice From The Pharmacist
- Metyrosine should be taken regularly to maintain steady levels of the drug in the body. Follow your doctor’s instructions closely regarding dosing adjustments.
- Drink plenty of water while taking metyrosine to prevent the formation of kidney stones, which can be a side effect.
- Regular blood pressure and catecholamine level monitoring is necessary to adjust the dose and ensure the medication is working effectively.
- Avoid sudden discontinuation of the medication, as this could lead to a rapid rise in catecholamine levels and a hypertensive crisis.
Side Effects of metyroSINE
Common Side Effects
- Sedation or drowsiness
- Diarrhea
- Nasal congestion
- Extrapyramidal symptoms (muscle stiffness or tremors)
- Anxiety or restlessness
Uncommon/Severe Side Effects
- Kidney stones
- Severe fatigue or lethargy
- Depression or mood changes
Risks and Warnings of metyroSINE
- Sedation: Metyrosine can cause significant drowsiness, affecting your ability to perform tasks that require alertness, such as driving. Avoid such activities until you know how the medication affects you.
- Kidney Stones: Metyrosine increases the risk of developing kidney stones. It is important to maintain adequate hydration and report any symptoms of pain during urination or blood in the urine to your healthcare provider.
- Extrapyramidal Symptoms: Some patients may develop muscle stiffness, tremors, or other movement disorders while taking metyrosine. Report any abnormal movements to your doctor.
Interactions with metyroSINE
Common Drug Interactions
- Sedatives and alcohol: Combining metyrosine with alcohol or other sedating medications (such as benzodiazepines or opioids) can enhance its sedative effects, leading to increased drowsiness or respiratory depression.
- Antihypertensives: Metyrosine may enhance the effects of other blood pressure-lowering medications, so blood pressure should be carefully monitored to avoid excessive drops.
- Levodopa: Metyrosine may reduce the effectiveness of levodopa (used in Parkinson’s disease) by inhibiting catecholamine production.
Alternatives to metyroSINE
- Phenoxybenzamine: An alpha-blocker used to control blood pressure in patients with pheochromocytoma before surgery.
- Beta-blockers: Often used in conjunction with alpha-blockers to manage heart rate and blood pressure in patients with pheochromocytoma.
- Surgical removal of the pheochromocytoma: The definitive treatment for pheochromocytoma is often surgery, with medications like metyrosine used preoperatively or for inoperable cases.
