Mecamylamine, a secondary amine, readily penetrates into the brain and thus may produce central
nervous system effects. Tremor, choreiform movements, mental aberrations, and convulsions may occur
rarely. These have occurred most often when large doses of Mecamylamine HCl were used, especially
in patients with cerebral or renal insufficiency.
When ganglion blockers or other potent antihypertensive drugs are discontinued suddenly, hypertensive
levels return. In patients with malignant hypertension and others, this may occur abruptly and may cause
fatal cerebral vascular accidents or acute congestive heart failure. When Mecamylamine HCl is
withdrawn, this should be done gradually and other antihypertensive therapy usually must be substituted.
On the other hand, the effects of Mecamylamine HCl sometimes may last from hours to days after
therapy is discontinued.
The patient's condition should be evaluated carefully, particularly as to renal and cardiovascular
function. When renal, cerebral, or coronary blood flow is deficient, any additional impairment, which
might result from added hypotension, must be avoided. The use of Mecamylamine HCl in patients with
marked cerebral and coronary arteriosclerosis or after a recent cerebral accident requires caution.
The action of Mecamylamine HCl may be potentiated by excessive heat, fever, infection, hemorrhage,
pregnancy, anesthesia, surgery, vigorous exercise, other antihypertensive drugs, alcohol, and salt
depletion as a result of diminished intake or increased excretion due to diarrhea, vomiting, excessive
sweating, or diuretics.
During therapy with Mecamylamine HCl, sodium intake should not be restricted but, if necessary, the
dosage of the ganglion blocker must be adjusted.
Since urinary retention may occur in patients on ganglion blockers, caution is required in patients with
prostatic hypertrophy, bladder neck obstruction, and urethral stricture.
Frequent loose bowel movements with abdominal distention and decreased borborygmi may be the first
signs of paralytic ileus. If these are present, Mecamylamine HCl should be discontinued immediately
and remedial steps taken.
Carcinogenesis, Mutagenesis, Impairment Of Fertility
Long-term studies in animals have not been performed to evaluate the effects upon fertility, mutagenic
or carcinogenic potential of Mecamylamine HCl.
Pregnancy Category C
Animal reproduction studies have not been conducted with Mecamylamine HCl.
It is not known whether Mecamylamine HCl can cause fetal harm when given to a pregnant woman or can
affect reproductive capacity. Mecamylamine HCl should be given to a pregnant woman only if clearly
Because of the potential for serious adverse reactions in nursing infants from Mecamylamine HCl, a
decision should be made whether to discontinue nursing or to discontinue the drug, taking into account
the importance of the drug to the mother.
Safety and effectiveness in pediatric patients have not been established.