Guanidine is available as tablets for oral administration. It is used in the symptomatic treatment of Lambert-Eaton Myasthenic syndrome.
Guanidine Uses:
- It is used to reduce fatigue and the symptoms of muscle weakness that are associated with Lambert Eaton myasthenic syndrome.
- It is not indicated for the treatment of myasthenia gravis.
Guanidine Dose in Adults
Guanidine Dose in the treatment of Eaton-Lambert syndrome:
- 10-15 mg/kg/day orally in 3 or 4 divided doses initially.
- The dose is then increased gradually to 35 mg/kg/day, or until toxicity develops.
Use in Children:
Not indicated in children.
Guanidine pregnancy Risk Category: N (Not defined)
- It has not yet been tested in animal reproduction studies or humans.
Use while breastfeeding
- It can be excreted in breastmilk. The manufacturer does not recommend breastfeeding.
Guanidine Dose in Kidney disease:
Adjustment in the dose has not been recommended in patients with kidney disease.
Guanidine Dose in Liver disease:
Adjustment in the dose has not been recommended in patients with liver disease by the manufacture
Side effects of Guanidine:
-
Cardiovascular:
- Atrial Fibrillation
- Cold Extremities
- Flushing
- Hypotension
- Palpitations
- Tachycardia
-
Central Nervous System:
- Ataxia
- Confusion
- Dizziness
- Emotional Lability
- Hallucination
- Irritability
- Jitteriness
- Mood Changes
- Nervousness
- Psychosis
-
Dermatologic:
- Diaphoresis
- Folliculitis
- Paresthesia
- Skin Rash
- Xeroderma
-
Gastrointestinal:
- Abdominal Cramps
- Anorexia
- Diarrhea
- Gastric Irritation
- Nausea
- Sore Throat
- Xerostomia
-
Genitourinary:
- Uremia
-
Hematologic & Oncologic:
- Anemia
- Bone-Marrow Depression
- Bruise
- Leukopenia
- Petechia
- Purpura
- Thrombocytopenia
-
Hepatic:
- Abnormal Hepatic Function Tests
-
Neuromuscular & Skeletal:
- Tremor
-
Renal:
- Increased Serum Creatinine
- Interstitial Nephritis (Acute Or Chronic)
- Renal Tubular Necrosis
-
Miscellaneous:
- Fever
Contraindications to Guanidine:
Severe allergic reactions to any component of the drug or the drug itself
Warnings and precautions
-
Suppression of bone marrow
- Its use has been linked to severe bone marrow suppression.
- Patients taking medications that suppress bonemarrow function should be advised to discontinue the use of the drug.
- Bone marrow suppression should be closely monitored.
- If bone marrow suppression is suspected, the treatment should be stopped immediately
-
Renal impairment
- Patients with impaired renal function should be cautious when taking the drug.
Guanidine: Drug Interaction
|
Risk Factor C (Monitor therapy) |
|
|
Acetylcholinesterase Inhibitors |
May worsen the hazardous or harmful effects of cholinergic antagonists. |
|
Beta-Blockers |
May worsen the hazardous or harmful effects of cholinergic antagonists. The possibilities for bronchoconstriction and aberrant cardiac conduction are of special concern. Management: Use cautious while combining these drugs, and keep an eye out for conduction issues. Because methacholine may cause further bronchoconstriction when used with any beta blocker, avoid using it. |
|
Cimetropium |
The anticholinergic action of cimetropium may be reduced by cholinergic antagonists. |
|
Risk Factor D (Consider therapy modification) |
|
|
Sincalide |
The therapeutic benefit of Sincalide may be reduced by medications that affect gallbladder function. Prior to using sincalide to induce gallbladder contraction, you should think about stopping any medications that can impair gallbladder motility. |
Monitoring parameters:
- CBC with differential counts at baseline and periodically thereafter
- Renal function (creatinine, BUN) and
- urinalysis at regular intervals.
How to administer?
It is administered orally without regard to meals.
Mechanism of action of Guanidine:
- It increases the release of Acetylcholine from the presynaptic nervous terminals, slowing down the depolarization/repolarization of cell membranes.
- It is easily availableIntakeDistributed and has been aEliminating half-lifeBetween 7 and 8 hours
International Brands of Guanidine Hydrochloride:
- Guanidine
Guanidine Brand Names in Pakistan:
No Brands Available in Pakistan. [
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