Mephentermine

Indications
 Intravenous
Maintenance of blood pressure in hypotensive states
Adult: 30-45 mg as a single dose, repeated as necessary or followed by IV infusion of 0.1% mephentermine in 5% dextrose, rate and duration of administration will depend on patient's response.
Intravenous
Hypotension secondary to spinal anaesthesia in obstetric patients
Adult: 15 mg as a single dose, repeat if needed.
Contraindications
 Hypotension caused by phenothiazines. Hypertension. Phaeochromocytoma.
Warnings / Precautions
 Patient on MAOIs. For shock due to loss of blood or fluid, give fluid replacement therapy primarily, CVS disease, hypertension, hyperthyroidism, chronic illnesses. Lactation, pregnancy.
Adverse Reactions
 Drowsiness, incoherence, hallucinations, convulsions, tachycardia. Fear, anxiety, restlessness, tremor, insomnia, confusion, irritability and psychosis. Nausea, vomiting, reduced appetite, urinary retention, dyspnoea, weakness.
Potentially Fatal: AV block, CNS stimulation. Cerebral haemorrhage and pulmonary oedema, ventricular arrhythmias.
Drug Interactions
 Antagonises effect of hypotensive agents. Severe hypertension with MAOIs and possibly TCAs. Additive vasoconstricting effects with ergot alkaloids, oxytocin.
Potentially Fatal: Risk of arrhythmia in patients undergoing anesthesia with cyclopropane and halothane.
See Below for More mephentermine Drug Interactions
Mechanism of Actions
 Mephentermine appears to act by indirect stimulation of β-adrenergic receptors causing the release of norepinephrine from its storage sites. It has a positive inotropic effect on the myocardium. AV conduction and refractory period of AV node is shortened with an increase in ventricular conduction velocity. It dilates arteries and arterioles in the skeletal muscle and mesenteric vascular beds, leading to an increase in venous return.
Onset: 5-15 minutes (IM), immediate (IV).
Duration: 4 hr (IM), 30 minutes (IV).
Metabolism: Rapidly demethylated in the body followed by hydroxylation.
Excretion: Via urine (as unchanged and metabolites); more rapid in acidic urine.
ATC Classification
 C01CA11 - mephentermine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.
Available As
  • Mephentermine 10 mg
  • Mephentermine 15 mg
  • Mephentermine 30 mg

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