Dosing & Uses
Dosage Forms & Strengths
tablet
- 125mg
Lambert-Eaton Myasthenic Syndrome
Indicated to symptoms of muscle weakness and fatigue associated with Eaton-Lambert myasthenic syndrome (LEMS)
10-15 mg/kg/day PO divided in 3-4 doses initially; may gradually increase to 35 mg/kg total daily dose as tolerated
Dosage Modifications
Renal or hepatic impairment: No dosage adjustment provided in prescribing information
Dosing Considerations
Measure blood counts with differentials at baseline and regularly thereafter
Monitor renal function
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (1)
- trilaciclib
trilaciclib will decrease the level or effect of guanidine by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.
Monitor Closely (0)
Minor (0)
Adverse Effects
Frequency Not Defined
Hematologic: Anemia, leukopenia, thrombocytopenia owing to bone marrow suppression
General: Sore throat, rash, fever
Neurologic: Paresthesia of lips, face, hands, feet; cold sensations in hands and feet; nervousness, lightheadedness, jitteriness, increased irritability; tremor, trembling sensation; ataxia; emotional lability; psychotic state; confusion; mood changes, and hallucinations
Gastrointestinal: Dry mouth; gastric irritation; anorexia; nausea; diarrhea; abdominal cramping
Dermatologic: Rash, flushing or pink complexion; folliculitis; petechiae, purpura, ecchymoses; sweating; skin eruptions; dryness and scaling of the skin
Renal: Elevation of blood creatinine, uremia; chronic interstitial nephritis, acute interstitial nephritis, and renal tubular necrosis
Hepatic: Abnormal liver function tests
Cardiac: Palpitation, tachycardia, atrial fibrillation, hypotension
Warnings
Contraindications
Hypersensitivity
Cautions
Fatal bone-marrow suppression, apparently dose related, can occur
Discontinue upon appearance of bone marrow suppression
May cause renal impairment; regularly measure serum creatinine
Use cautiously with hepatic disease; drug-induced liver dysfunction may occur
GI adverse effects may occur; significant GI disease (eg, peptic ulcer disease) may preclude guanidine use
Use caution with history of psychosis; carefully monitor patients with known behavioral or mood disorders
Drug interactions overview
- Avoid coadministration with other drugs that cause bone marrow suppression
Pregnancy & Lactation
Pregnancy
Owing to a lack of data assessing fetal risk, and the potential for hematologic, neurologic, and cardiac toxicity associated with the drug, guanidine should be used during pregnancy only if clearly needed
Lactation
Excreted in breast milk; discontinue breastfeeding during treatment
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Acts by enhancing acetylcholine release following nerve impulses; also slows depolarization and repolarization rates of muscle cell membranes
Administration
Oral Administration
Administer daily dosage in 3-4 divided doses
Storage
Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)
Images
Formulary
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