DEMSER is indicated in the treatment of patients with pheochromocytoma for:

1. Preoperative preparation of patients for surgery
2. Management of patients when surgery is contraindicated
3. Chronic treatment of patients with malignant pheochromocytoma.

DEMSER is not recommended for the control of essential hypertension.

The recommended initial dosage of DEMSER for adults and children 12 years of age and older is 250 mg orally four times daily. This may be increased by 250 mg to 500 mg every day to a maximum of 4.0 g/day in divided doses. When used for preoperative preparation, the optimally effective dosage of DEMSER should be given for at least five to seven days.

Optimally effective dosages of DEMSER usually are between 2.0 and 3.0 g/day, and the dose should be titrated by monitoring clinical symptoms and catecholamine excretion. In patients who are hypertensive, dosage should be titrated to achieve normalization of blood pressure and control of clinical symptoms. In patients who are usually normotensive, dosage should be titrated to the amount that will reduce urinary metanephrines and/or vanillylmandelic acid by 50 percent or more.

If patients are not adequately controlled by the use of DEMSER, an alpha-adrenergic blocking agent (phenoxybenzamine) should be added.

Use of DEMSER in children under 12 years of age has been limited and a dosage schedule for this age group cannot be given.

No. 3355 Capsules DEMSER, 250 mg, are opaque, two-toned blue capsules coded MSD 690 on one side and DEMSER on the other. They are supplied as follows:

NDC 0006-0690-68 bottles of 100.

COPYRIGHT© MERCK & CO., INC., 1985

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