Dichlorphenamide

KEVEYIS

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Dichlorphenamide ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Dichlorphenamide ballicule

Dichlorphenamide KEVEYIS mascot mnemonic cartoon — Visual mnemonic: Dichlorphenamide mascot
**“Kevin’s Dice cooler”**

What it isCarbonic anhydrase inhibitor; primary periodic paralysis.

Why this oneIt reduces attack frequency in both hyperkalemic and hypokalemic periodic paralysis, which no other agent covers.

What limits itParaesthesia, cognitive slowing and kidney stones. It is a sulfonamide.

Dichlorphenamide molecular structure (skeletal formula) — Molecular structure: Dichlorphenamide

FDA-approved for

periodic paralysis (2015)

FDA label

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FDA dosing	Population	Start	Target	Max
Primary hyper-/hypokalemic periodic paralysis and related variants	Adults	50 mg QD or BID	individualized	200 mg/day

Titration Adjust at weekly intervals (or sooner if adverse reaction).

Renal Undefined

Hepatic Contraindicated in hepatic insufficiency.

Instructions

Evaluate response after 2 months of treatment to decide whether to continue
Monitor serum potassium and bicarbonate at baseline and periodically

Available strengths

tab 50 mg

Contraindications

Hypersensitivity to dichlorphenamide or other sulfonamides
Concomitant use with high-dose aspirin
Severe pulmonary disease limiting compensation to metabolic acidosis
Hepatic insufficiency

Cautions

Hypersensitivity / immune-mediated reactions; discontinue at first sign of rash
Hypokalemia; monitor and correct
Metabolic acidosis; monitor serum bicarbonate
Falls; consider dose reduction/discontinuation

Adverse reactions

Paresthesias
Cognitive disorder
Dysgeusia
Confusional state

Pregnancy No adequate human data; teratogenic in rats; may cause fetal harm.

Lactation No data on presence in human milk or effects on the breastfed infant.

Cost

Dichlorphenamide (KEVEYIS)

Strength		#/mo	generic $/mo	CostPlus
50 mg	tab	30 qd		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Dichlorphenamide is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2022

NO BOXED WARNINGS

Principal riskParaesthesia and kidney stones

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.

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Memory aids: interaction avatars

urinary alkalinizer

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