metyrosine
Metyrosine (Demser) is used to treat symptoms of a rare type of tumor called pheochromocytoma. It’s typically taken 4 times a day by mouth, and comes as both brand-name and generic capsules. The most common side effect is drowsiness, but this usually gets better within a few days of starting the medication.
What is Metyrosine (Demser)?
What is Metyrosine (Demser) used for?
- Treatment of pheochromocytoma for:
- Preparation for surgery to remove the tumors
- People who aren't able to have surgery
- Long-term treatment of people with malignant pheochromocytoma (cancer)
How Metyrosine (Demser) works
Metyrosine (Demser) is a tyrosine hydroxylase inhibitor, meaning it blocks a protein in the body called tyrosine hydroxylase. This protein is responsible for making hormones called catecholamines.
People who have pheochromocytoma have tumors that make too many of these catecholamines. So metyrosine (Demser) works by lowering the amount of catecholamines that are made. This can reduce the symptoms like high blood pressure, headaches, sweating, and a fast heart beat.
Drug facts
Side effects of Metyrosine (Demser)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
These side effects occurred in at least 10% of people taking the medication:
- Drowsiness
- Drooling
- Difficulty speaking
- Shakiness
- Diarrhea
Less Common Side Effects
- Anxiety
- Depression
- Confusion
- Stuffy nose
- Dry mouth
- Headache
- Enlarged breasts
- Nausea
- Stomach pain
- Difficulty getting or maintaining an erection
- Painful urination
Metyrosine (Demser) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Mental health changes: depression, hallucinations (seeing things that aren't there), confusion
- Extrapyramidal symptoms (EPS): drooling, trouble speaking, tremor, muscle spasms, tightness in your jaw
- Low blood cell counts: feeling tired, paleness, blood in urine or stool, unexplained bruising
- Severe allergic reaction: hives, swelling in the throat, trouble breathing
The following Metyrosine (Demser) side effects have also been reported
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 as soon as possible if any of the following side effects occur:
Less common
confusion
hallucinations (seeing, hearing, or feeling things that are not there)
mental depression
Rare
Black, tarry stools
blood in urine or stools
unusual bleeding or bruising
muscle spasms, especially of neck and back
pinpoint red spots on skin
restlessness
shortness of breath
shuffling walk
skin rash and itching
swelling of feet or lower legs
tic-like (jerky) movements of head, face, mouth, and neck
unusual tiredness or weakness
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:
More common
Drowsiness
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
More common
Also, after you stop taking this medicine, you may have feelings of increased energy or you may have trouble sleeping. However, these effects should last only for two or three days.
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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Pros and cons of Metyrosine (Demser)
Pros
- Dose can be adjusted based on your response to the medication
- A good option for people who can't have surgery
- Can work well to lower the amount of hormones causing symptoms
- Can be added to other pheochromocytoma treatments like phenoxybenzamine (Dibenzyline)
- Available as a lower-cost generic
Cons
- Must be taken 4 times a day
- Must drink plenty of fluids while taking this medication to lower the risk of kidney stones
- Commonly causes drowsiness and diarrhea
- Unknown if safe or works well in children under 12 years old
- Interacts with many other medications
Pharmacist tips for Metyrosine (Demser)
- Set an alarm to help you remember to take all of your doses of metyrosine (Demser) each day.
- Drowsiness is a common side effect of metyrosine (Demser). Avoid alcohol and other sedating medications (e.g., sleeping medications, muscle relaxants). Make sure you know how this medication affects you before driving or doing activities that require you to be alert.
- It's important to drink plenty of fluids while taking metyrosine (Demser). This will help prevent the medication from forming crystals in your urine, which could lead to kidney stones.
- If you experience diarrhea while taking metyrosine (Demser), talk to your provider about ways to manage it if you need to continue taking the medication.
- Provide your healthcare team with a current list of your medications. Metyrosine (Demser) can interact with many medications, including phenothiazines and haloperidol (Haldol). Your provider or pharmacist can check to make sure your medications are safe to take together.
- After you stop taking metyrosine (Demser), you might experience trouble sleeping and possibly feel even more alert. This effect usually lasts for 2 to 3 days. Don’t stop taking this medication without talking with your provider.
Common questions about Metyrosine (Demser)
Pheochromocytoma is a rare and usually non-cancerous tumor that's typically found within your adrenal glands. The adrenal glands are responsible for releasing hormones called catecholamines into your blood. Many times, the tumor in pheochromocytoma produces too many catecholamines. This can cause symptoms like high blood pressure, sweating, a racing heart, shakiness, and headaches. Metyrosine (Demser) is used to lower the amount of catecholamines being made to help relieve these symptoms.
While everyone responds differently to metyrosine (Demser), it generally takes about 2 to 3 days for it to reach its maximum effect. You might notice your blood pressure going down slowly over the first 2 days of treatment. But if you aren't getting relief after this time, talk to your provider. They might need to change your dose.
No. Metyrosine (Demser) can't cure pheochromocytoma, but it can help treat its symptoms. This medication works best if you take it consistently every day. Once you stop taking metyrosine (Demser), the hormone levels in your body will return to how they were before within 3 or 4 days. This means your symptoms will likely come back gradually over a few days after your last dose.
It's best to avoid drinking alcohol while taking metyrosine (Demser). This is because alcohol commonly causes drowsiness, and metyrosine (Demser) can make this effect even stronger. The combination of these two sedating substances can be dangerous, especially when you’re driving or doing activities that require you to be alert.
There isn't enough information to know if metyrosine (Demser) is safe to take while pregnant. If you're pregnant or thinking of becoming pregnant, speak with your provider about the risks and benefits of this medication.
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Risks and warnings for Metyrosine (Demser)
Metyrosine (Demser) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Crystals in the urine
- Risk factors: Low fluids in the body | High doses of metyrosine (Demser)
Metyrosine (Demser) can cause crystals to form in the urine, which could lead to problems like kidney stones. Signs of kidney stones include painful urination, fever, and sometimes blood in the urine. The risk is higher if your dose of metyrosine (Demser) is more than 2 grams per day. To lower this risk, make sure you drink plenty of fluids. Your provider will test your urine regularly to make sure you don't have crystals in it.
Excessive drowsiness
Metyrosine (Demser) can cause you to feel very sleepy and less alert. This usually happens within the first 24 hours of starting this medication and might get worse for 2 or 3 days. It should get better with time, but if it doesn't, you should let your provider know. Avoid taking this medication with alcohol or other medications like sleeping pills, opioid pain medications, and muscle relaxants. Be sure to know how the medication affects you before driving or performing activities that require you to be alert.
Metyrosine (Demser) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg of | 120 capsules | $11,460.90 | $95.51 |
Interactions between Metyrosine (Demser) and other drugs
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.
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