From the FDA Drug Label
Use of any dosage forms in patients with known hypersensitivity to trimethobenzamide is contraindicated. The contraindication for Tigan (trimethobenzamide) is:
- Known hypersensitivity to trimethobenzamide 1
From the Research
Tigan (trimethobenzamide) is contraindicated in patients with known hypersensitivity to the drug or its components, as well as those with severe liver or kidney disease, due to the risk of accumulation to toxic levels 2, 3, 4. The medication should not be used in patients with Parkinson's disease or those taking medications that can cause extrapyramidal reactions, as Tigan may worsen these symptoms due to its dopamine-blocking properties. Some key points to consider when prescribing Tigan include:
- Contraindication in children with viral illnesses, particularly those with signs of Reye's syndrome, due to increased risk of neurological complications
- Avoidance in patients with severe liver or kidney disease as it may accumulate to toxic levels
- Caution in pregnant women, as safety during pregnancy is not well established
- Caution in elderly patients who are more susceptible to anticholinergic effects and sedation
- Caution in patients taking CNS depressants due to potential additive sedative effects
- Caution in those with a history of seizures, as Tigan may lower the seizure threshold A study published in 2014 found that trimethobenzamide can help reduce nausea and vomiting during the first 8 weeks of apomorphine therapy, but is generally not needed thereafter 5. However, the most recent and highest quality evidence should be prioritized when making clinical decisions, and the 2020 update on hepatotoxicity of agents used in the management of inflammatory bowel disease highlights the importance of monitoring for liver-related adverse events 4.