Adult Dosing
Differential diagnosis of myasthenia gravis
IV
- Prepare tuberculin syringe with an IV needle containing 1 mL (10mg) of solution
- Inject 0.2 mL (2mg) IV within 15-30 secs, keep needle in situ
- Inject 0.8 mL (8mg) IV only if no reaction occurs after 45 seconds
Note Discontinue the test and administer atropine sulfate 0.4-0.5 mg IV if cholinergic reaction like muscarinic side effects, skeletal muscle fasciculations and increased muscle weakness occurs on injection of 0.2 mL (2mg) IV. Repeat the test after one-half hr
IM
Note Repeat the test after one-half hr with injecting 0.2 mL (2mg) IM if cholinergic reactions have occurred on injecting 1 mL (10mg) IM. This is done to rule out false-negative reactions
Evaluation of treatment requirements in myasthenia gravis
IV
- Inject 0.1-0.2 mL (1mg-2mg) IV 1 hr after oral intake of the drug being used in the treatment
For management of crisis
IV
- Do not fill >0.2 mL (2mg) in syringe
- Initial dose: Inject 0.1mL (1mg) IV, Monitor action on heart
- Inject remaining 0.1 mL (1mg) IV if no impairment in patient has occurred after 1 minute of administering initial dose
Note: Discontinue anticholinesterase drug therapy if no improvement of respiration occurs after injecting dose of 0.2 mL (2mg) IV. Controlled ventilation should be given by tracheostomy with assisted respiration
Non depolarising neuromuscular blockade reversal
IV
- Inject 1 mL (10mg) IV over a period of 30-45 seconds
- Max dose: 4 mL (40mg) IV
Note:
- Use only when needed
- Do not administer prior to administration of curare, tubocurarine, gallamine triethiodide or dimethyl-tubocurarine
- Carefully monitor effect of each dose before repeating of dose, proper ventilation should be supplied
- Visually inspect for particulate matter and discoloration prior to administration
Pediatric Dosing
Differential diagnosis of myasthenia gravis
IV
- Inject 0.1mL (1mg) IV for body weight =75lbs
- Inject 0.2mL (2mg) IV for body weight >75lbs
- Titrate dose upto 0.5 mL (5mg) IV for body weight <75lbs if there is no response after 45 seconds, administer in increments of 0.1 mL (1mg) IV q30-45 seconds upto 1 mL (10mg) in heavier children
- For infants recommended dose: 0.05 mL (0.5mg) IV
IM
- Inject 0.2 mL (2mg) IM for body weight =75lbs
- Inject 0.5 mL (5mg) IM for body weight >75lbs
Note: Delayed reactions may occur within 2-10 minutes as compared to IV tests
[Outline]
See Supplemental Patient Information
- Administer 1 mg of atropine sulfate IV to counteract severe cholinergic reactions occurred in hypersensitive individual whether normal or myasthenic in adults
- Transient bradycardia may occur which can be relieved by atropine sulphate
- Vagotonic effects like cardiac and respiratory arrest may occur rarely
- Fatal/less severe asthmatic episodes, anaphylactic reactions may occur due to presence of sulfites in formulations
- Anticholinesterase insensitivity may occur for short or long duration; monitor patient and provide respiratory assistance when required
- Monitor hyperreactive individuals for severe cholinergic reactions
- Monitor I.V. site closely
- Monitor patients for bradycardia, cardiac arrest and cholinergic reactions on overdose
Cautions: Use cautiously in
Supplemental Patient Information
- Advise patient to report vision changes
Pregnancy Category:C
Breastfeeding: Safety is not established for use during pregnancy or lactation in humans. Manufacturer advices use taking into account the importance of the drug to the mother, weighing potential benefits as compared to risks.
US Trade Name(s)
US Availability
edrophonium (generic) [Discontinued]
Enlon
- INJ: 10 mg/mL (15 mL vial)
Tensilon
Canadian Trade Name(s)
Canadian Availability
Tensilon
- INJ: 10 mg/mL (10 mL vial)
UK Trade Name(s)
UK Availability
edrophonium (generic)
Australian Trade Name(s)
Australian Availability
[Outline]