Sunday, May 11, 2008

Ambenonium

U.S. BRAND NAMES — Mytelase®
PHARMACOLOGIC CATEGORY Cholinergic Agonist
DOSING: ADULTS — Myasthenia gravis: Oral: 5-25 mg 3-4 times/day
DOSING: ELDERLY — Refer to adult dosing.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Caplet, as chloride [scored]: Mytelase®: 10 mg
DOSAGE FORMS: CONCISE Caplet [scored]: Mytelase®: 10 mg
GENERIC EQUIVALENT AVAILABLE — No
USE — Treatment of myasthenia gravis
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Cardiovascular: Arrhythmias (especially bradycardia), hypotension, carbon monoxide decreased, tachycardia, AV block, nodal rhythm, ECG changes (nonspecific), cardiac arrest, syncope, flushing
Central nervous system: Convulsions, dysarthria, dysphonia, dizziness, loss of consciousness, drowsiness, headache
Dermatologic: Skin rash, thrombophlebitis (I.V.), urticaria
Gastrointestinal: Hyperperistalsis, nausea, vomiting, salivation, diarrhea, stomach cramps, dysphagia, flatulence
Genitourinary: Urinary urgency
Neuromuscular & skeletal: Weakness, fasciculations, muscle cramps, spasms, arthralgia
Ocular: Small pupils, lacrimation
Respiratory: Bronchial secretions increased, laryngospasm, bronchiolar constriction, respiratory muscle paralysis, dyspnea, respiratory depression, respiratory arrest, bronchospasm
Miscellaneous: Diaphoresis increased, anaphylaxis, allergic reactions
CONTRAINDICATIONS — Routine administration of atropine or other belladonna alkaloids with ambenonium is contraindicated because they may suppress the muscarinic symptoms of excessive gastrointestinal stimulation, leaving only the more serious symptoms of muscle fasciculations and paralysis as signs of overdosage; should not be administered to patients receiving mecamylamine
WARNINGS / PRECAUTIONS — Prolonged action after cholinergics; drug should be discontinued until the patient is stabilized. Use with caution in patients with asthma, epilepsy, bradycardia, hyperthyroidism, or peptic ulcer. Differentiation of cholinergic/myasthenia crisis is critical; use edrophonium and clinical judgment. Anticholinergic insensitivity may develop for brief or prolonged periods. Reduce or withhold dosages until the patient becomes sensitive again. May require respiratory support.
PREGNANCY RISK FACTOR — C (show table)
LACTATION — Excretion in breast milk unknown/not recommended
PRICING — (data from drugstore.com)Tablets (Mytelase) 10 mg (100): $134.76
CANADIAN BRAND NAMES — Mytelase®
INTERNATIONAL BRAND NAMES — Mytelase (CA, PL); Mytelase Chloride (CZ, FR, HU, SE)

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