Methoxamine (Vasoxyl)

Category:

  • Nervous system

Description:

  • Vasopressor

Indications:

  • Hypotension during anesthesia

  • Supraventricular paroxysmal tachycardia

Contraindications:

  • Severe hypertension

Precautions:

  • Pregnancy category C

  • Children, hypovolemia, extravasation (phentolamine is antidote), hyperthyroidism

  • Bradycardia, partial heart block, myocardial disease, severe arteriosclerosis

  • Sulfite sensitivity

Adverse Reactions (Side Effects):

  • CNS: anxiety, headache (often severe)

  • CV: excessive blood pressure elevation, ventricular ectopic beats

  • GI: nausea, vomiting (often projectile)

  • GU: fetal bradycardia, urinary urgency, uterine hypertonus

  • SKIN: pilomotor response, sweating

Dosage:

Administered intramuscularly, intravenously

  • Adult: 

    • During spinal anesthesia: 

      • IM 10-20mg shortly before or with spinal anesthesia; repeat as needed

    • Emergencies:

      • IV 3-5mg injected slowly

    • Supraventricular tachycardia:

      •  IV 10mg injected slowly

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