Patient/caregiver was educated on contraindications for using Metaxall as follows:
- Metaxall is extensively metabolized in the liver and the inactive metabolites are mainly excreted in the urine. If liver function is deficient, the metabolism of metaxall can be compromised. This can lead to increased blood levels of the medication for longer periods of time, resulting in increased risk for side-effects and consequent toxicity. So, in individuals with history of compromised liver function, metaxall must be used with caution and possible multiple dose adjustments, periodical monitoring for liver functions and development of any toxicity symptoms with the medication.
- Metaxall could interact with a number of other medications and can precipitate serious reactions. If you are being newly started on metaxall, discuss with your physician regarding all other medications you are currently taking and their safety with metaxall. Also, if you have been taking metaxall for long, discuss with your physician regarding your history of metaxall intake, when you are being started on any new medication.
- Metaxall use, especially in individuals with history of mood disorders, can occasionally result in exacerbation of mania and depressive symptoms, changes in behavior, hallucinations, and compromised sexual drive. Metaxall must either be avoided for an alternative or used with extra caution in individuals with such history, to prevent exacerbation of mood disorders.
- Metaxall must be avoided in individuals with history of severe head injury and brain damage. Individuals with history of head injury and brain damage can be at a very high risk to present with severe depression of brain and associated respiratory centers with metaxall, leading to complications such as, coma, breathing difficulty, and respiratory arrest, which can be fatal.
