Guanidine

Guanidine Brand Name– Guanidine

What is Guanidine

Guanidine is an oral cholinergic muscle stimulant.

Guanidine is indicated for the reduction of the symptoms of muscle weakness and easy fatigability associated with the myasthenic syndrome of Lambert-Eaton. Guanidine is not indicated for use in myasthenia gravis.

Lambert-Eaton can usually be differentiated from myasthenia gravis by the presence of small cell carcinoma of the lung, but myography may be necessary for a definitive diagnosis.

Gastrointestinal adverse events (e.g., nausea, diarrhea, abdominal cramping) may preclude use in some patients.

Guanidine has been used clinically since 1939.

Indications

  • Lambert-Eaton syndrome

For the reduction of the symptoms of muscle weakness and easy fatigability associated with Lambert-Eaton syndrome

Side Effects

  1. anemia
  2. anorexia
  3. anxiety
  4. ataxia
  5. atrial fibrillation
  6. confusion
  7. diarrhea
  8. ecchymosis
  9. elevated hepatic enzymes
  10. emotional lability
  11. fever
  12. flushing
  13. folliculitis
  14. gastritis
  15. hallucinations
  16. hyperhidrosis
  17. hypotension
  18. interstitial nephritis
  19. irritability
  20. leukopenia
  21. nausea
  22. palpitations
  23. paresthesias
  24. petechiae
  25. pharyngitis
  26. psychosis
  27. purpura
  28. rash
  29. renal tubular necrosis
  30. restlessness
  31. sinus tachycardia
  32. thrombocytopenia
  33. tremor
  34. xerosis
  35. xerostomia

Monitoring Parameters

  • CBC with differential
  • neurologic function
  • serum creatinine
  • urinalysis

Contraindications

  • anemia
  • bone marrow suppression
  • breast-feeding
  • children
  • GI disease
  • hepatic disease
  • infants
  • leukopenia
  • neonates
  • peptic ulcer disease
  • pregnancy
  • psychosis
  • renal impairment
  • thrombocytopenia

Interactions

  • Ambenonium Chloride
  • Amoxapine
  • Anticholinergics
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Bethanechol
  • Carbamazepine
  • Cevimeline
  • Chlordiazepoxide; Clidinium
  • Chlorpromazine
  • Cholinesterase inhibitors
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Dextromethorphan; Promethazine
  • Dicyclomine
  • Disopyramide
  • Donepezil
  • Donepezil; Memantine
  • Edrophonium
  • Felbamate
  • Flavoxate
  • Fluphenazine
  • Galantamine
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Homatropine; Hydrocodone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Indacaterol; Glycopyrrolate
  • Maprotiline
  • Mepenzolate
  • Meperidine; Promethazine
  • Mesoridazine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Neostigmine
  • Oxybutynin
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Physostigmine
  • Pilocarpine
  • Pralidoxime
  • Prochlorperazine
  • Promethazine
  • Propantheline
  • Pyridostigmine
  • Rivastigmine
  • Scopolamine
  • Sulfinpyrazone
  • Tacrine
  • Thiethylperazine
  • Thioridazine
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trospium