Sodium phenylacetate and benzoate (intravenous route)


    Brand Name

    US Brand Name

    Ammonul


    Description

    Sodium phenylacetate and benzoate injection combination is used to treat hyperammonemia, which is a condition where there is too much ammonia in the blood. Ammonia is formed from the breakdown of protein in the body. If the ammonia cannot be removed by the body, high amounts in the blood may cause serious unwanted effects. This medicine works to reduce the amount of ammonia in the blood.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    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 this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of sodium phenylacetate and benzoate injection in children.

    Geriatric

    Although appropriate studies on the relationship of age to the effects of sodium phenylacetate and benzoate injection have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving sodium phenylacetate and benzoate injection.

    Breastfeeding

    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.

    Drug Interactions

    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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

    Other Interactions

    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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Congestive heart failure or
    • Edema (swelling) or
    • Hyperglycemia (high blood sugar) or
    • Hypokalemia (low potassium in the blood) or
    • Seizures (convulsions), history of—Use with caution. May make these conditions worse.
    • Kidney disease or
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A nurse or other trained health professional will give you or your child this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

    Your doctor will give you or your child a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

    It is also important that you follow any special diet instructions from your doctor, such as using a low protein diet. If you have any questions about this, check with your doctor.


    Precautions

    It is very important that your doctor check your or your child's progress closely while you are receiving this medicine to make sure the medicine is working properly. Blood tests may be needed to check for unwanted effects.

    This medicine may cause unwanted effects on the nervous system. Check with your doctor right away if you or your child have lightheadedness, muscle tingling or weakness, sleepiness or unusual drowsiness, or tiredness.

    Check with your doctor right away if you or your child have more than one of the following symptoms while receiving this medicine: confusion; deep or fast breathing with dizziness; muscle tremors; nausea; numbness of the feet, hands, and around the mouth; rapid, deep breathing; restlessness; stomach cramps; or unusual tiredness or weakness.


    Side Effects

    Along with its needed effects, a medicine 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 or nurse immediately if any of the following side effects occur:

    More common

    • Abdominal or stomach pain or cramps
    • blurred vision
    • decreased urine
    • dry mouth
    • fatigue
    • flushed, dry skin
    • fruit-like breath odor
    • increased hunger
    • increased thirst
    • increased urination
    • irregular heartbeat
    • loss of appetite
    • muscle pain or cramps
    • nausea or vomiting
    • numbness or tingling in the hands, feet, or lips
    • seizures
    • shortness of breath
    • sweating
    • troubled breathing
    • unexplained weight loss
    • unusual tiredness or weakness

    Less common

    • Agitation
    • anxiety
    • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
    • bleeding or oozing from the puncture site, mouth, or nose that continues
    • bloody or cloudy urine
    • bloody, black, or tarry stools
    • confusion
    • coughing that sometimes produces a pink frothy sputum
    • depression
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • drowsiness
    • feeling, seeing, or hearing things that are not there
    • feeling that others are watching you or controlling your behavior
    • headache
    • lightheadedness
    • mood or mental changes
    • muscle tremors
    • nightmares or unusually vivid dreams
    • pale skin
    • rapid, deep breathing
    • restlessness
    • skin rash
    • sleepiness or unusual drowsiness
    • trouble with breathing when moving or walking
    • unusual bleeding or bruising

    Some side effects 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:

    Less common

    • Diarrhea
    • fever

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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