II. Indications

  1. Hypertensive Crisis of Pheochromocytoma
    1. Not indicated in routine benign Hypertension

III. Mechanism

  1. Synthetic dibenzamine Alpha Adrenergic Antagonist at post-synaptic Adrenergic Receptors (alpha-1 and alpha-2)
  2. Binding results in non-selective, irreversible alkylation of the Alpha Adrenergic Receptor
  3. Causes Smooth Muscle relaxation, blocking Vasoconstriction and vasospasm

IV. Dosing: Adults

  1. Start 10 mg orally twice daily
  2. Titrate to typical dose 20 to 40 mg orally twice daily
  3. Maximum total daily dose: 120 mg/day

V. Dosing: Children (Not FDA approved)

  1. Start 0.2 mg/kg/day (up to 20 mg/day or 10 mg/dose) divided twice daily orally
  2. May titrate 0.4 to 1.2 mg/kg/day up to 20 to 40 mg orally twice daily

VI. Adverse Effects

  1. Symptomatic Hypotension
    1. Observe after dosing
  2. Reflex Tachycardia
  3. Possibly carcinogenic

VII. Safety

  1. Pregnancy Category C
  2. Unknown Safety in Lactation

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