For the management of moderately severe to severe essential hypertension and in uncomplicated cases of malignant hypertension.

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Essential Hypertension -- hypertension occurring without preexisting renal disease or known organic cause.

Malignant Hypertension -- A condition of markedly elevated BLOOD PRESSURE with DIASTOLIC PRESSURE usually greater than 120 mm Hg. Malignant hypertension is characterized by widespread vascular damage, PAPILLEDEMA, retinopathy, HYPERTENSIVE ENCEPHALOPATHY, and renal dysfunction.

INVERSINE should not be used in mild, moderate, labile hypertension and may prove unsuitable in uncooperative patients.

It is contraindicated in coronary insufficiency or recent myocardial infarction.INVERSINE should be given with great discretion, if at all, when renal insufficiency is manifested by a rising or elevated BUN.

The drug is contraindicated in uremia.

Patients receiving antibiotics and sulfonamides should generally not be treated with ganglion blockers.

Other contraindications are glaucoma, organic pyloric stenosis or hypersensitivity to the product.

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LABILE HYPERTENSION --

Renal Insufficiency -- Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE. The most severe form is KIDNEY FAILURE. Renal function may deteriorate slowly (RENAL INSUFFICIENCY, CHRONIC) or precipitously (RENAL INSUFFICIENCY, ACUTE).

Uremia -- A clinical syndrome associated with the retention of renal waste products or uremic toxins in the blood. It is usually the result of RENAL INSUFFICIENCY. Most uremic toxins are end products of protein or nitrogen CATABOLISM, such as UREA or CREATININE. Severe uremia can lead to multiple organ dysfunctions with a constellation of symptoms.

Glaucoma -- An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed)

Hypersensitivity -- Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen.

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 INVERSINE 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 INVERSINE is withdrawn, this should be done gradually and other antihypertensive therapy usually must be substituted.

On the other hand, the effects of INVERSINE sometimes may last from hours to days after therapy is discontinued.