Appetrol

A carbamate with hypnotic, sedative, and some muscle relaxant properties, although in therapeutic doses reduction of anxiety rather than a direct effect may be responsible for muscle relaxation. Appetrol has been reported to have anticonvulsant actions against petit mal seizures, but not against grand mal seizures (which may be exacerbated). It is used in the treatment of anxiety disorders, and also for the short-term management of insomnia but has largely been superseded by the benzodiazepines. (From Martindale, The Extra Pharmacopoeia, 30th ed, p603) Appetrol is a controlled substance in the U.S.

Oral

Obesity

Adult: As extended-release cap: 20-50 mg once daily after breakfast for up to 4 wk.

Oral

Obesity

Adult: As extended-release cap: 20-50 mg once daily after breakfast for up to 4 wk.

Patients treated with MAOI or stopped MAOI within the last 2 wk; moderate or severe hypertension; pulmonary hypertension; structural cardiac abnormalities or advanced arteriosclerosis; adrenal tumour; hyperthyroidism or hyperexcitability; coronary thrombosis; closed-angle glaucoma; pregnancy.

Reduced effect of guanethidine. Increased risk of arrhythmia in patients treated with digitalis due to its sympathomimetic effects. Increased risk of arrhythmia with choroform, cyclopropane, halothane or other halogenated anesthetics. The effect of Appetrol may be reduced/enhanced by tricyclic anti-depressants.

Potentially Fatal: Appetrol should not be used in patients treated with a MAOI or within 14 days of stopping MAOI as hypertensive crisis may occur if used.

In large doses giddiness, headache, nausea, vomiting, sweating, dryness of the mouth and thirst, tachycardia, precordial pain, palpitation, difficulty in micturition, muscular weakness and tremors, anxiety, restlessness and insomnia may occur.

Some patients may exhibit these symptoms with the therapeutic dose. These agents may produce psychotic reactions, agitation and excitability. They should be used with caution in patients with history of psychiatric illness. Prolonged administration has no cumulative effect but tolerance with dependence has been reported.

Use with caution in patients receiving chloroform, cyclopropane, halothane or other halogenated anaesthetics.

this medicine may diminish the effects of guanethidine and may increase the possibility of arrythmias in digitalised patients. this medicine should be taken with caution by patients with organic heart disease, cardiac decompensation or angina of effort in patients receiving digitalis.

The effects of this medicine may be diminished or enhanced by tricyclic anti-depressants.

In patients with prostatic enlargement, it may increase difficulty with micturition.

The preparation should not be taken late in the afternoon because of its stimulant effect on the central nervous system.

These agents are liable to be abused. They should be used with extreme caution in patients with a history of drug or alcohol abuse and in patients with personality disorders. There is a lack of evidence for efficacy in the long-term management of obesity.

Systolic and diastolic blood pressure may be increased, especially with high doses and anginal pain or cardiac arrhythmia’s may occur.

These agents should be administered cautiously to patients suffering from cardiovascular disease (especially coronary insufficiency), hypertension, thyrotoxicosis and narrow angle glaucoma.