Patient/caregiver was educated on contraindications for using Pamelor as follows:
- Pamelor use in expectant mothers could increase risk for pregnancy complications, such as, miscarriage. Newborns can also present with harmful side-effects of the medication. Pamelor can cross the placenta and enter the baby. Newborns exposed to Pamelor in the uterus can present with harmful side-effects of the medication, such as, respiratory depression, breathing difficulties, developmental delays, and other toxicity with the medication. After birth, newborns could also demonstrate symptoms of sudden withdrawal from the medication and present with listlessness, lack of energy, sleep disturbances, appetite changes, feeding difficulties, and seizures. So, Pamelor is cautiously administered with careful monitoring or avoided for an alternative drug during pregnancy and in women planning for pregnancy. Women in the child-bearing age group taking Pamelor must employ effective contraceptive measures in order to avoid getting pregnant.
- Pamelor is extensively metabolized in the liver and the metabolites are mainly excreted in the urine. If liver function is deficient, the metabolism of Pamelor can be compromised. In individuals with history of compromised renal function, the excretion of Pamelor metabolites can be compromised. In either case, Pamelor and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Pamelor could be cautiously administered in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
