Dichlorphenamide

You should not use dichlorphenamide if you are allergic to it, or if you have:

• severe breathing problems;

• kidney failure;

• liver disease;

• an allergy to sulfa drugs; or

• if you also take aspirin in high doses.

In addition to the above, you should not use Daranide if you have an electrolyte imbalance (such as acidosis or low levels of potassium or sodium in your blood).

To make sure dichlorphenamide is safe for you, tell your doctor if you have:

• kidney disease.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether dichlorphenamide passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Administration

Oral Administration

Administer orally.1

Dosage

Adults

Initially, 50 mg twice daily.1 Adjust dosage at weekly intervals (or sooner if adverse effects occur) based on individual response.1

Because response to dichlorphenamide may vary, assess patient response after 2 months of therapy to determine whether the drug should be continued.1

For reduction in intraocular pressure, initial dose of 100–200 mg has been recommended, followed by 100 mg every 12 hours until desired response obtained.8 Usual maintenance dosage is 25–50 mg 1–3 times daily.8

Prescribing Limits

Adults

200 mg daily.1

Special Populations

No special population dosage recommendations at this time.1

Drugs Associated with Hypokalemia

Potential additive pharmacologic effects (increased risk of hypokalemia).1 (See Hypokalemia under Cautions.)

Drugs Associated with Metabolic Acidosis

Potential increased risk and severity of metabolic acidosis.1 (See Metabolic Acidosis under Cautions.)

Specific Drugs

Storage

Oral

20–25°C.1

• Importance of advising patients to contact their clinician if symptoms of periodic paralysis worsen.1

• Importance of advising patients that dichlorphenamide can cause drowsiness or fatigue and impair their ability to drive or operate machinery.1

• Importance of patients informing their clinician if they are allergic to sulfonamides.1

• Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1

• Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs (e.g., aspirin) and dietary or herbal supplements, as well as any concomitant illnesses (e.g., pulmonary disease, hepatic disease).1

• Importance of informing patients of other important precautionary information.1 (See Cautions.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dichlorphenamide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to dichlorphenamide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of dichlorphenamide in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dichlorphenamide in the elderly. However, elderly patients are more likely to have falls or metabolic acidosis, which may require caution in patients receiving dichlorphenamide.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dichlorphenamide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using dichlorphenamide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Aspirin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of dichlorphenamide. Make sure you tell your doctor if you have any other medical problems, especially:

• Adrenal problems or
• Hyperchloremic metabolic acidosis or
• Respiratory acidosis—May increase risk for hypokalemia.

• Allergy to sulfa drugs or
• Liver disease or
• Lung disease, severe—Should not be used in patients with these conditions.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Evaluate response after 2 months of treatment. Monitor serum potassium and serum sodium bicarbonate at baseline and periodically throughout treatment.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience change in taste, headache, loss of strength and energy, dizziness, diarrhea, nausea, weight loss, joint pain, or throat pain. Have patient report immediately to prescriber signs of low potassium (muscle pain or weakness, muscle cramps, or an abnormal heartbeat), signs of acidosis (confusion, fast breathing, tachycardia, abnormal heartbeat, severe abdominal pain, nausea, vomiting, fatigue, shortness of breath, or loss of strength and energy), burning or numbness feeling, confusion, difficulty focusing, shortness of breath, or signs of a severe sulfonamide reaction (rash; red, swollen, blistered, or peeling skin; red or irritated eyes; mouth, throat, nose, or eye sores; fever, chills, or pharyngitis; cough that is new or worse; loss of strength and energy; any bruising or bleeding; or signs of liver problems like dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, or jaundice) (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating, and advising patients.

Applies to dichlorphenamide: oral tablet

Along with its needed effects, dichlorphenamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking dichlorphenamide:

• Abdominal or stomach pain
• black, tarry stools
• blistering, peeling, or loosening of the skin
• chest pain or discomfort
• chills
• confusion
• convulsions
• cough or hoarseness
• dark urine
• decreased urine
• diarrhea
• dilated neck veins
• dizziness
• drowsiness
• dry mouth
• extreme fatigue
• fever with or without chills
• general feeling of tiredness or weakness
• headache
• increased thirst
• irregular breathing
• irregular heartbeat
• itching or rash
• joint or muscle pain
• light-colored stools
• loss of appetite
• lower back or side pain
• mood changes
• muscle pain or cramps
• nausea or vomiting
• numbness or tingling in the hands, feet, or lips
• painful or difficult urination
• rapid, deep breathing
• red skin lesions, often with a purple center
• red, irritated eyes
• restlessness
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips
• stomach cramps
• swelling of the face, fingers, feet, or lower legs
• swollen or painful glands
• tightness in the chest
• unpleasant breath odor
• unusual bleeding or bruising
• unusual tiredness or weakness
• vomiting of blood
• weight gain
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking dichlorphenamide:

• Bloody or cloudy urine
• bloody, black, or tarry stools
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• continuing ringing or buzzing or other unexplained noise in the ears
• difficult or painful urination
• fainting
• hearing loss
• high fever
• pale skin
• shakiness and unsteady walk
• shakiness in the legs, arms, hands, or feet
• sudden decrease in the amount of urine
• unsteadiness, trembling, or other problems with muscle control or coordination

Some side effects of dichlorphenamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• change in taste
• difficulty with moving
• general feeling of discomfort or illness
• loss of taste
• muscle pain or stiffness
• muscle spasms
• muscle twitching
• pain in the joints
• trouble performing routine tasks
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

• Decreased awareness or responsiveness
• loss of memory
• problems with memory
• seeing, hearing, or feeling things that are not there
• severe sleepiness

Contraindicated in hepatic insufficiency

Data not available