From the FDA Drug Label
Use of any dosage forms in patients with known hypersensitivity to trimethobenzamide is contraindicated. The contraindication for using Tigan (trimethobenzamide) is a known hypersensitivity to trimethobenzamide 1.
- The drug label does not provide a comprehensive list of precautions, but it does mention that reduction in dosing may be advisable in elderly patients with renal impairment and patients with renal impairment 1.
From the Research
Tigan (trimethobenzamide) is contraindicated in patients with known hypersensitivity to the drug or its components, and its use should be cautiously considered in various conditions to minimize risks to morbidity, mortality, and quality of life. The primary concerns with Tigan include its potential to worsen symptoms in patients with Parkinson's disease due to its dopamine-blocking properties, although a study from [2014@] found that trimethobenzamide did not worsen parkinsonism nor affect the "on" response after apomorphine injection [@2@]. Key precautions and contraindications for Tigan use include:
- Known hypersensitivity to the drug or its components
- Children with symptoms of viral illnesses due to the risk of Reye's syndrome
- Caution in patients with liver or kidney disease, as the drug is metabolized by the liver and excreted by the kidneys
- Patients with seizure disorders, as Tigan may lower the seizure threshold
- Elderly patients, who may be more sensitive to side effects, particularly anticholinergic effects and sedation
- Patients with gastrointestinal obstruction, as Tigan may mask symptoms and delay diagnosis
- Pregnant women, where benefits must clearly outweigh risks (Pregnancy Category C), and nursing mothers, who should be aware the drug may pass into breast milk
- Patients should avoid driving or operating machinery until they know how the medication affects them due to potential drowsiness. Understanding hypersensitivity reactions, as classified in a [2019@] review 2, is also crucial in managing patients on Tigan, emphasizing the need for careful patient selection and monitoring.