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Propafenone and alcohol: [Propafenon and alcohol: effect of this combination of behavioral performance and the subjective condition in healthy volunteers]

pms-Propafenone – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Propafenone belongs to the class of medications known as antiarrhythmics. It is used to treat certain abnormal heart rhythms. It works by slowing down the rate of nerve impulses causing the heart to beat, and by making the heart less likely to respond to abnormal impulses.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

pms-Propafenone is no longer being manufactured for sale in Canada. For brands that may still be available, search under propafenone. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The recommended starting dose of propafenone for adults is 150 mg taken every 8 hours. This dose may be changed by your doctor according to your particular needs. The maximum daily dose is 900 mg per day.

Propafenone should be taken with food. Swallow the tablets whole. Do not crush or chew this medication.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take propafenone if you:

  • are allergic to propafenone or any ingredients of the medication
  • are taking the medication “ritonavir”
  • have a very low heart rate (less than 50 beats per minute)
  • have breathing disorders such as asthma or obstructive pulmonary disease
  • have cardiogenic shock
  • have certain types of heart rhythm disorders not managed with a pacemaker (i.e., sino-atrial, atrioventricular, and intraventricular disorders of impulse conduction and sinus node dysfunction)
  • have had a heart attack in the last 3 months
  • have myasthenia gravis
  • have severe disorders of electrolytes (e.g., potassium) balance
  • have severe liver failure
  • have severe or uncontrolled congestive heart failure
  • have very low blood pressure
  • have been diagnosed with Brugada Syndrome (a type of heart rhythm disorder)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain or cramping
  • bitter or metallic taste, or changes in taste
  • blurred vision
  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • gas
  • headache
  • heartburn
  • increased sweating
  • insomnia
  • lightheadedness
  • loss of appetite
  • nausea
  • rash
  • tiredness
  • upset stomach
  • vomiting
  • weakness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal muscle control and movement
  • anxiety
  • fainting
  • fast, slow, or irregular heartbeat
  • joint pain
  • shaking or trembling
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
  • signs of decreased heart function (e.g., shortness of breath, swelling of feet or lower legs, unusual tiredness or weakness)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • swelling of feet or lower legs

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • seizures
  • signs of a serious allergic reaction (e. g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Abnormal heart rhythms: Certain medications used to treat abnormal heart rhythms, including propafenone, may cause new abnormal heart rhythms or worsen existing ones. Your doctor will monitor you closely while you are taking propafenone. If you experience a fast, slow, or irregular heartbeat; fainting; heart palpitations; or dizziness while taking this medication, contact your doctor immediately.

Asthma or bronchitis: Propafenone can worsen breathing problems for people with asthma or bronchitis. If you have asthma or other breathing disorders, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Propafenone may cause blurred vision, dizziness, and fatigue. Do not drive or operate machinery until you know how this medication affects you.

Heart failure: Propafenone can cause or worsen heart failure and should not be used by people with severe or untreated heart failure. If you have heart failure and are taking this medication, your doctor will monitor you closely during treatment. If you notice shortness of breath; weight gain; or swelling in the hands, feet, or lower legs while taking propafenone, contact your doctor immediately.

If you have a heart condition, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: Propafenone can reduce the number of cells that fight infection in the body (white blood cells). This usually occurs within 4 to 6 weeks of starting this medication. If you experience fever, sore throat, fatigue, weakness, or a general feeling of being unwell while taking propafenone, contact your doctor immediately.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: The liver removes most of this medication from the body. Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Pregnancy: Propafenone crosses the placenta and may affect the developing baby if it is taken during pregnancy. This medication should not be taken during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking propafenone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may experience more dizziness while taking propafenone and may require lower doses.

What other drugs could interact with this medication?

There may be an interaction between propafenone and any of the following:

  • abiraterone
  • aliskiren
  • alpha-agonists (e.g., clonidine, methyldopa)
  • antiarrythmics (e.g., amiodarone, disopyramide, dronedarone, flecainide, procainamide, quinidine, sotalol)
  • anticancer medications (e.g., brentuximab, daunorubicin, docetaxel, doxorubicin, etoposide, irinotecan, mitomycin, paclitaxel, tamoxifen, vinblastine, vincristine)
  • antihistamines (e. g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, pimozide, paliperidone, risperidone)
  • apalutamide
  • aprepitant
  • “azole” antifungals (e.g., ketoconazole, fluconazole, voriconazole)
  • beta-adrenergic blockers (e.g., metoprolol, propranolol)
  • BCG
  • bicalutamide
  • bupropion
  • calcium channel blockers (e.g., diltiazem, verapamil)
  • chloroquine
  • cimetidine
  • cinacalcet
  • cobicistat
  • colchicine
  • conivaptan
  • cyclosporine
  • dabigatran
  • darifenacin
  • digoxin
  • domperidone
  • donepezil
  • doxepin
  • edoxaban
  • enzalutamide
  • everolimus
  • fentanyl
  • fingolimod
  • galantamine
  • “gliptin” diabetes medications (e.g., linagliptin, saxagliptin, sitagliptin)
  • grapefruit juice
  • guanfacine
  • HIV protease inhibitors (e. g., fosamprenavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir)
  • hydrocortisone
  • ivabradine
  • ivermectin
  • ledipasvir
  • lanreotide
  • letermovir
  • lidocaine
  • loperamide
  • lovastatin
  • lumacaftor and ivacaftor
  • macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
  • methadone
  • methotrexate
  • mifepristone
  • mirabegron
  • morphine
  • naloxegol
  • octreotide
  • ondansetron
  • orlistat
  • pasireotide
  • prucalopride
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, moxifloxacin)
  • ranitidine
  • rifampin
  • rifaximin
  • riociguat
  • rivastigmine
  • romidepsin
  • St. John’s wort
  • seizure medications (e.g., carbamazepine, lacosamide, phenobarbital, phenytoin, primidone)
  • selective serotonin reuptake inhibitors (SSRIs; citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline)
  • silodosin
  • siponimod
  • sofosbuvir
  • tacrolimus
  • terbinafine
  • theophylline medications (e. g., aminophylline, oxtriphylline, theophylline)
  • tizanidine
  • tofacitinib
  • tolvaptan
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine)
  • tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
  • venlafaxine
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/pms-Propafenone

Propafenone Hcl Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Though this medication often gives great benefits to people with irregular heartbeat, it may rarely cause a serious new irregular heartbeat. Talk with your doctor about the benefits and risks of taking this medication.

Warnings:

Though this medication often gives great benefits to people with irregular heartbeat, it may rarely cause a serious new irregular heartbeat. Talk with your doctor about the benefits and risks of taking this medication.

… Show More

Uses

This medication is used to help prevent certain types of serious (possibly fatal) irregular heartbeat (such as paroxysmal supraventricular tachycardia and atrial fibrillation). It is used to help maintain a regular, steady heartbeat. Propafenone is known as an anti-arrhythmic drug. It works by blocking the activity of certain electrical signals in the heart that can cause an irregular heartbeat. Treating an irregular heartbeat can decrease the risk for blood clots, and this effect can reduce your risk of heart attack or stroke.

How to use Propafenone Hcl oral

Read the Patient Information Leaflet if available from your pharmacist before you start taking propafenone extended-release capsules and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually every 12 hours. Swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

See also Warning section.

Dizziness, headache, metallic/salty taste in the mouth, nausea/vomiting, constipation, anxiety, and tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: signs of infection (such as sore throat that doesn’t go away, high fever, severe chills, weakness), signs of liver problems (such as nausea/vomiting that doesn’t stop, stomach/abdominal pain, yellowing eyes/skin, dark urine), worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

Get medical help right away if you have any very serious side effects, including: fainting, faster/more irregular heartbeat, severe dizziness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking propafenone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, chronic bronchitis, emphysema), kidney problems, liver problems, myasthenia gravis, a certain inherited heart condition (Brugada Syndrome).

Propafenone may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using propafenone, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using propafenone safely.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).

This medication can affect fertility in males. Ask your doctor for more details.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Many drugs besides propafenone may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, flecainide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as erythromycin), and certain quinolone antibiotics (such as sparfloxacin), among others.

Other medications can affect the removal of propafenone from your body, which may affect how propafenone works. Examples include asunaprevir, desipramine, ketoconazole, orlistat, phenobarbital, phenytoin, ritonavir, certain HIV protease inhibitors (such as tipranavir), among others.

Propafenone can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include digoxin, fezolinetant, imipramine, metoprolol, propranolol, warfarin, among others.

Does Propafenone Hcl oral interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, very slow heartbeat, new irregular heartbeat, fainting.

Do not share this medication with others.

Lab and/or medical tests (such as EKG) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Doctors explained the effect of a small amount of alcohol on the heart

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Atrial fibrillation is the most common heart rhythm disorder. Its main complications are stroke and heart failure. The insidiousness of this disease lies in the fact that the patient either does not feel it, or simply feels a rapid heartbeat, not associating it with heart problems.

At the same time, the symptoms associated with arrhythmias – fatigue, dizziness, chest pain and shortness of breath – are often attributed to a common malaise. Meanwhile, atrial fibrillation increases the risk of stroke by five times.

What are the causes of atrial fibrillation? Among the risk factors are not only heart disease, high blood pressure, obesity and thyroid disease. It seems that the recent discovery of South Korean scientists will add to this list. It turned out that even small doses of alcohol affect the violation of the heart rhythm.

This was found out during the large-scale long-term national health screening program in South Korea. Scientists were able not only to assess how common heart disease is among the population, but also to understand the causes of their occurrence. Including doctors managed to establish how seriously alcohol affects the heart rhythm.

The fact that the risk of atrial fibrillation is associated with the amount of alcohol consumed has long been known. Doctors know “a linear correlation between alcohol and atrial fibrillation: every 12 g of alcohol per week (one drink) increases the likelihood of developing the disease by 8%. But it was not clear what had a greater effect – the total amount of alcohol consumed or the frequency of use.

The study answered this question: those who drink little but regularly are more at risk.

Scientists analyzed the data 9776,956 people who did not have arrhythmia at the beginning of observations. For eight years, they were observed by a cardiologist – until the second passage of the program in 2017.

Based, among other things, on the data of the questionnaire, the authors of the work calculated how many times a week the patients consumed alcohol, what was the average dose of alcohol per day and per week.

“Our study shows that frequent drinking is more dangerous,” said Dr. Chen Il Choi of Korea University College of Medicine in Seoul. “In order to protect yourself from atrial fibrillation, it is important to drink as little as possible. In addition, drinking alcohol can trigger sleep disturbance, which is a known risk factor for atrial fibrillation.”

Scientists noted that those who drank a little, but daily, atrial fibrillation occurred 1.41 times more often than those who drank twice a week (age and gender did not matter).

Thus, the best protection against arrhythmia, Dr. Choi believes, is the occasional alcohol consumption: “Atrial fibrillation is associated with a deterioration in the quality of life and can lead to various complications. Therefore, it is better to prevent the disease than to treat it later. Alcohol is one of the risk factors that is easy to eliminate, and it is important not only to reduce the total dose of alcohol, but also to reduce the frequency of its use.”

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Free metanephrine and free normetanephrine in urine

Free metanephrine and free normetanephrine in urine is one of the breakdown products of adrenaline. It is used in the diagnosis of a tumor of the adrenal glands – pheochromocytoma.

Synonyms English

Free metanephrine urine, Fractionated metanephrine urine.

Test method

High performance liquid chromatography with tandem mass spectrometry.

Units

µg/day (micrograms per day).

What biomaterial can be used for research?

Daily urine.

How to properly prepare for an examination?

  • Eliminate alcohol from the diet for 24 hours prior to the study.
  • Eliminate avocados, bananas, eggplants, pineapples, plums, tomatoes, walnuts from the diet within 72 hours prior to the study.
  • Exclude (in agreement with the doctor) taking tetracycline antibiotics, quinidine, reserpine, tranquilizers, adrenoblockers, MAO inhibitors within 4 days before the study.
  • Exclude (in agreement with the doctor) the use of diuretics within 48 hours before urine collection.
  • The study is not recommended during menstruation.
  • Exclude physical and emotional overstrain during the collection of daily urine (during the day).

General information about the study

Metanephrines are the end products of the breakdown of catecholamines: adrenaline and norepinephrine.

Catecholamines are hormones produced in the adrenal glands, small triangular organs located at the upper poles of both kidneys. There are three types of catecholamines: dopamine, epinephrine (epinephrine), and norepinephrine. These hormones are released into the blood in response to physical stress or emotional stress. They are involved in the transmission of nerve impulses in the brain, help release glucose and fatty acids (which are used as a source of energy), enlarge the small bronchi in the lungs, and also help dilate the pupils. Norepinephrine also constricts blood vessels, resulting in a rise in blood pressure, while epinephrine increases heart rate and speeds up metabolism.

After fulfilling their function in the body, catecholamines are converted into inactive forms: dopamine into homovanillic acid, norepinephrine into normetanephrine and vanillylmandelic acid, and adrenaline into metanephrine and vanillylmandelic acid. Both the hormones themselves and their metabolites are then excreted in the urine. At the same time, modern analyzers make it possible to distinguish between free and bound forms of metanephrines in urine.

This assay is much more sensitive and specific than epinephrine, as adrenaline is degraded within minutes of being released from cells. Moreover, the test for free metanephrine is more valuable in the diagnosis of pheochromocytoma than the determination of the total content of metanephrines.

Normal urine contains a small amount of free metanephrine, which increases significantly during and after stress. Pheochromocytoma and other neuroendocrine tumors can produce huge amounts of catecholamines, which leads to an increase in the concentration of these hormones in the blood and urine. Excessive production of catecholamines, in turn, causes a persistent increase in blood pressure (and / or episodes of its sharp increase). Other symptoms of the effect of catecholamines on the body: headache, sweating, nausea, anxiety and tingling in the limbs.

Most pheochromocytomas are located in the adrenal glands. As a rule, they are benign – they do not spread beyond the place where they formed, although they continue to grow slowly. If a pheochromocytoma is left untreated, the symptoms gradually become more pronounced as it grows: high blood pressure – hypertension – damages various organs, including the kidneys and heart, and also increases the risk of heart attack and stroke.

Although pheochromocytoma is a fairly rare disease, it is extremely important to diagnose and treat this tumor in a timely manner, because it causes a form of arterial hypertension that can be treated. In most cases, the tumor can be surgically removed and/or treated with medication, which can reduce the amount of catecholamines in the blood, relieve symptoms of the disease, and prevent complications.

Usually this test is ordered together with the determination of urine normetanephrines. Since the level of catecholamines in the blood changes during the day, a urine sample collected during the day is used for analysis.

What is research used for?

  • To diagnose pheochromocytoma for those who have characteristic symptoms of this tumor.
  • To evaluate the effectiveness of the treatment of pheochromocytoma.

When is the test scheduled?

  • If pheochromocytoma is suspected. It can be assumed by the following symptoms: persistent increase in blood pressure (and / or episodes of its sharp increase), increased heart rate, hot flashes, sweating.
  • For arterial hypertension that is difficult to treat.
  • If a tumor of the adrenal glands or other neuroendocrine tumor was incidentally detected during an ultrasound or MRI examination, or such a tumor was in the immediate family of the patient.

What do the results mean?

Reference values ​​

  • Metanephrine free

Sex

Reference values, mcg/day

Female

7.69 – 33.33

Male

8.84 – 53.25

  • Normetanephrine free

Sex

Reference values, mcg/day

Female

7.91 – 35.18

Male

8.76 – 43.24

Causes of changes in metanephrine levels

Given that the test result for metanephrine is sensitive to various factors and that pheochromocytoma is quite rare, it must be remembered that false positive results are possible. However, when the patient has characteristic symptoms and there is a significant increase in urinary metanephrine, further investigation is required. For greater reliability of the results, together with free metanephrine in the urine, total metanephrines in the urine, as well as normetanephrines, can be investigated. If they are also elevated, then an MRI of the adrenal region is performed to confirm the diagnosis of pheochromocytoma.

An increase in metanephrine in a patient with a previously diagnosed pheochromocytoma may indicate that the treatment was not effective enough or that the tumor has recurred.

The normal values ​​obtained as a result of this analysis are a strong argument against the diagnosis of “pheochromocytoma”: if the level of free metanephrine is not elevated, then it can be excluded with a high probability.

In addition to pheochromocytoma, metanephrine may be elevated in paraganglioma or neuroblastoma, tumors of the nervous tissue.

An increase in the concentration of metanephrine is also noted in sepsis.

What can influence the result?

Metanephrine levels can be increased by:

  • strenuous exercise,
  • coffee, tea, caffeine,
  • alcohol, nicotine,
  • adelfan, insulin, diuretics, paracetamol, propafenone, antibiotic tetracycline, tricyclic antidepressants, vasoconstrictor nasal drops and sprays, eufillin.

Important notes

  • The metanephrine test detects the presence of a pheochromocytoma, but it does not tell how large the tumor is, whether it is benign or not, how many tumor nodes are in total. Even small pheochromocytomas can produce a lot of catecholamines.
  • The patient should discuss with the doctor which of the medications taken should be excluded during the analysis.
  • The result of this study may be affected by the use of certain drugs, certain foods, psycho-emotional stress, which can lead to inflated values. Therefore, the use of a urine metanephrine test is not recommended as a screening test.