Sodium Benzoate and Sodium Phenylacetate

What is Sodium Benzoate and Sodium Phenylacetate combination medicine

Sodium benzoate and sodium phenylacetate are used together in an injectable preparation as an adjunctive treatment of acute hyperammonemia.

The oral form of sodium benzoate; sodium phenylacetate is no longer available in the United States.

Sodium benzoate; sodium phenylacetate provide an alternative pathway for waste nitrogen excretion in patients with disorders of the urea cycle. 

Brand Name

• Ammonul
• Ucephan

Indications & Dosage

• hyperammonemia

General dosing information:

• Uncontrolled hyperammonemia can rapidly cause brain damage or death and should be treated immediately, especially in neonates presenting with coma, regardless of whether the specific causative enzyme deficiency has been identified. If the enzyme deficiency is unknown, administer 600 mg/kg of arginine HCl over 90 minutes and an equivalent dose over 24 hours to all hyperammonemic infants with suspected urea cycle deficiency.
• Do not give more than one loading dose due to prolonged phenylacetate plasma concentrations and toxicity. In a trial, the mean treatment duration per episode was 4.6 days (range, 1—72 days).⁴⁸⁷⁷⁵

For the adjunctive treatment of acute hyperammonemia and associated encephalopathy in patients with deficiencies in enzymes of the urea cycle

for patients with carbamyl phosphate synthetase or ornithine transcarbamylase deficiency

Side Effects

1. acute respiratory distress syndrome (ARDS)
2. agitation
3. alopecia
4. anemia
5. anuria
6. asthenia
7. ataxia
8. bleeding
9. bradycardia
10. cardiac arrest
11. cardiomyopathy
12. cerebral degeneration
13. cerebral edema
14. chest pain (unspecified)
15. cholestasis
16. coagulopathy
17. coma
18. confusion
19. dehydration
20. diarrhea
21. disseminated intravascular coagulation (DIC)
22. dyspnea
23. edema
24. encephalopathy
25. fever
26. fluid retention
27. flushing
28. GI bleeding
29. hallucinations
30. hepatic failure
31. hyperammonemia
32. hyperglycemia
33. hyperkalemia
34. hypernatremia
35. hypertension
36. hyperventilation
37. hypocalcemia
38. hypoglycemia
39. hypokalemia
40. hyporeflexia
41. hypotension
42. impaired cognition
43. increased intracranial pressure
44. infection
45. injection site reaction
46. intracranial bleeding
47. irritability
48. jaundice
49. metabolic acidosis
50. nausea
51. pancytopenia
52. pericardial effusion
53. pneumothorax
54. pruritus
55. psychosis
56. pulmonary edema
57. rash
58. renal failure (unspecified)
59. seizures
60. skin necrosis
61. subdural hematoma
62. tachypnea
63. tetany
64. thrombocytopenia
65. thrombosis
66. tremor
67. urinary retention
68. urticaria
69. visual impairment
70. vomiting

Monitoring Parameters

• plasma ammonia concentrations
• serum bicarbonate
• serum creatinine/BUN
• serum electrolytes
• total CO2

Contraindications

• breast-feeding
• diabetes mellitus
• edema
• extravasation
• heart failure
• hepatic disease
• hypernatremia
• hypertension
• hypokalemia
• intraarterial administration
• intramuscular administration
• labor
• pregnancy
• renal failure
• renal impairment
• seizures
• sodium restriction

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Antacids
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Azelastine; Fluticasone
• Beclomethasone
• Betamethasone
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Budesonide
• Budesonide; Formoterol
• Calcium Carbonate; Magnesium Hydroxide
• Carbenicillin
• Choline Salicylate; Magnesium Salicylate
• Ciclesonide
• Colchicine
• Colchicine; Probenecid
• Corticosteroids
• Corticotropin, ACTH
• Cortisone
• Deflazacort
• Dexamethasone
• Dichlorphenamide
• Dicloxacillin
• Fludrocortisone
• Flunisolide
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Formoterol; Mometasone
• Hydrocortisone
• Magnesium Hydroxide
• Magnesium Salicylate
• Methadone
• Methylprednisolone
• Mometasone
• Nafcillin
• Omeprazole; Amoxicillin; Rifabutin
• Oxacillin
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Penicillins
• Piperacillin
• Piperacillin; Tazobactam
• Prednisolone
• Prednisone
• Probenecid
• Salsalate
• Sodium Phenylbutyrate
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Triamcinolone
• Valproic Acid, Divalproex Sodium