Tromethamine

Contraindications

Uremia

Anuria

Neonates: chronic respiratory acidosis, salicylate intoxication

Cautions

Renal impairment

Extravasation may cause inflammation & tissue necrosis

Administer slowly to avoid alkalosis

Risk of overhydration, that may cause serum electrolyte dilution, pulm edema, CHF

Risk of hypoglycemia with extremely large doses

Mechanism of Action

Corrects acidosis by acting as a proton acceptor; releases bicarbonate buffer to correct acidosis by combining with hydrogen ions

Pharmacokinetics

Distribution: Distributes into cellular extracellular space quickly; at steady state distributes into a volume slightly greater than total body water; penetrates slowly intracellularly

Half-life: 5.6 hr

Excretion: Urine within 8 hr (>75%)

Tromethamine affects the balance of water and electrolytes in the body.

Tromethamine is used to treat metabolic acidosis (an electrolyte imbalance). Metabolic acidosis can have many causes. It often occurs after heart bypass surgery or cardiac arrest.

Tromethamine may also be used for purposes not listed in this medication guide.

You should not receive tromethamine if you have uremia (urea circulating in your blood), or if you are unable to urinate (such as due to kidney failure).

You should not receive tromethamine if you are allergic to it, or if you have:

• uremia (urea circulating in your blood); or
• if you are unable to urinate.

If possible, before you receive tromethamine, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;
• congestive heart failure; or
• asthma or other breathing problems.

FDA pregnancy category C. It is not known whether tromethamine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether tromethamine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

Tromethamine is injected into a muscle, or into a vein through an IV. A healthcare provider will give you this injection.

Tromethamine is often given for only a short period of time, such as one day. The length of your treatment will depend on how your body responds to this medicine.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when tromethamine is injected.

To be sure this medication is not causing harmful effects, your blood and heart function will need to be checked throughout your treatment.

After treatment with tromethamine, you will be closely watched and tested to make sure the medicine has been effective and you no longer have any effects of metabolic acidosis.

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Overdose symptoms may include fast heart rate, swelling, trouble breathing, confusion, sweating, or seizure (convulsions).

Because you will receive tromethamine in a clinical setting, you are not likely to miss a dose.

Tromethamine is a prescription medication used to treat high acid levels in the body. This is medically known as metabolic acidosis. Tromethamine belongs to a group of drugs called alkalinizing agents. These help eliminate acidic components of the blood.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Common side effects of tromethamine are rare as it is given under the supervision of a healthcare professional.

Storage

Parenteral

20–25°C; do not freeze.100 Discard unused portions.100

(troe METH a meen)

• Tris Buffer
• Tris(hydroxymethyl)aminomethane

Hypersensitivity to tromethamine or any component of the formulation; uremia or anuria; chronic respiratory acidosis (neonates); salicylate intoxication (neonates)

Applies to tromethamine: compounding powder, intravenous solution

Cardiovascular

Frequency not reported: Chemical phlebitis, venospasms[Ref]

Dermatologic

Frequency not reported: Extravasation tissue damage and sloughing[Ref]

Endocrine

Frequency not reported: Transient depression of blood glucose[Ref]

Hepatic

Frequency not reported: Hepatocellular necrosis[Ref]

Local

Frequency not reported: Infection at site of injection, venous thrombosis or phlebitis from site of injection extravasation[Ref]

Metabolic

Frequency not reported: Hypervolemia[Ref]

Other

Frequency not reported: Febrile response[Ref]

Respiratory

Frequency not reported: Ventilatory depression, respiratory depression[Ref]

Some side effects of tromethamine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.