(GWAHN i deen)
- Guanidine Hydrochloride
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral, as hydrochloride:
Generic: 125 mg
- Cholinergic Agonist
Use: Labeled Indications
Reduction of the symptoms of muscle weakness associated with the myasthenic syndrome of Eaton-Lambert, not for myasthenia gravis
Hypersensitivity to guanidine or any component of the formulation
Adults: Oral: Eaton-Lambert syndrome: Initial: 10-15 mg/kg/day in 3-4 divided doses, gradually increase to 35 mg/kg/day or up to development of side effects
Dosage adjustment in renal impairment: No dosage adjustment provided in manufacturer’s labeling.
Dosage adjustment in hepatic impairment: No dosage adjustment provided in manufacturer’s labeling.
Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).
Acetylcholinesterase Inhibitors: May enhance the adverse/toxic effect of Cholinergic Agonists. Monitor therapy
Beta-Blockers: May enhance the adverse/toxic effect of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Management: Administer these agents in combination with caution, and monitor for conduction disturbances. Avoid methacholine with any beta blocker due to the potential for additive bronchoconstriction. Monitor therapy
Cimetropium: Cholinergic Agonists may diminish the anticholinergic effect of Cimetropium. Monitor therapy
Frequency not defined.
Cardiovascular: Atrial fibrillation, flushing, hypotension, palpitation, tachycardia
Central nervous system: Ataxia, confusion, emotional lability, fever, hallucination, irritability, jitteriness, lightheadedness, mood changes, nervousness, psychotic state
Dermatologic: Bruising, dry skin, folliculitis, petechiae, purpura, rash, skin eruptions
Gastrointestinal: Abdominal cramps, anorexia, diarrhea, gastric irritation, nausea, sore throat, xerostomia
Hematologic: Anemia, bone-marrow suppression, leukopenia, thrombocytopenia
Hepatic: Abnormal liver function tests
Neuromuscular & skeletal: Paresthesia, trembling, tremor
Renal: Creatinine increased, interstitial nephritis (acute or chronic), renal tubular necrosis, uremia
Miscellaneous: Cold extremities, diaphoresis
Concerns related to adverse effects:
• Bone marrow suppression: Dose-related, fatal bone marrow suppression had been reported with use. Avoid concurrent use with medications known to suppress bone marrow. Monitor closely; discontinue use if bone marrow suppression is suspected.
• Renal impairment: Use with caution in patients with renal impairment.
CBC with differential (baseline and frequently thereafter); creatinine, BUN, urinalysis
Animal reproduction studies have not been conducted.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience dyspepsia, flushing, hyperhidrosis, lack of appetite, diarrhea, abdominal cramps, or xerostomia. Have patient report immediately to prescriber signs of infection, signs of renal impairment, behavioral changes, severe dizziness, syncope, paresthesia, change in balance, tremors, illogical thinking, mood changes, hallucinations, arrhythmia, or tachycardia (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.