Edrophonium
TENSILON
What it isUltra-short cholinesterase inhibitor; historical myasthenia diagnosis.
Why this oneIts two-minute action allowed a bedside test that improved weakness within seconds.
What limits itBradycardia and cholinergic crisis required atropine at hand. Superseded by antibody and electrophysiological testing.
FDA-approved for
- myasthenia diagnosis (~1950)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Diagnosis of myasthenia gravis (IV test) | Adults | 2 mg IV; if no reaction after 45 sec give remaining 8 mg | — | 10 mg total |
| Diagnosis of myasthenia gravis (IV test) | Children | 1 mg (≤75 lb) or 2 mg (>75 lb) IV; infants 0.5 mg | Titrate in 1 mg increments | 5 mg (<75 lb) / 10 mg (heavier) |
| Curare antagonist | Adults | 10 mg IV slow over 30-45 sec | Repeat PRN | 40 mg |
Renal Undefined
Hepatic Undefined
Maximum 40 mg as a curare antagonist
Instructions
- IV: inject slowly over 30-45 seconds; have atropine available for cholinergic reaction
- IM route for patients with inaccessible veins
Available strengths
- inj 10 mg/mL
Contraindications
- Mechanical intestinal or urinary obstruction
Cautions
- Severe cholinergic reactions in hyperreactive individuals
- Bradycardia or cardiac standstill during crisis testing
- Keep atropine available
Adverse reactions
- Increased lacrimation/salivation/secretions
- Bradycardia/arrhythmias
- Hypotension
- Nausea, vomiting, diarrhea, abdominal cramps
- Muscle weakness/fasciculations
- Laryngospasm/bronchospasm
Pregnancy Undefined
Lactation Undefined
Cost
Edrophonium (TENSILON)
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 10 mg/mL | inj | per unit | not offered |
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Edrophonium is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.
NO BOXED WARNINGS
Principal riskCholinergic crisis; superseded by antibody testing
Classes and tags
Clinical profile
Defining liabilityAbrupt cholinergic bradycardia, bronchospasm and respiratory compromise