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edrophonium

Brand Name :

Enlon-plus, Enlon

Synonyms :

edrophonium

Class :

Antidote; Acetylcholinesterase Inhibitor; Diagnostic Agent





No data available for drug.

Actions and Spectrum: 

The mechanism of action of edrophonium involves the following steps: 

  • Inhibition of Acetylcholinesterase: edrophonium binds to and inhibits acetylcholinesterase, which breaks down acetylcholine in the synaptic cleft. By inhibiting AChE, edrophonium prevents the rapid breakdown of acetylcholine, leading to an increased concentration of acetylcholine in the synapse. 
  • Enhanced Cholinergic Transmission: The increased concentration of acetylcholine in the synapse prolongs the interaction of acetylcholine with postsynaptic cholinergic receptors. This enhances cholinergic transmission and promotes the activation of muscarinic and nicotinic receptors. 
  • Increased Stimulation of Muscarinic Receptors: The activation of muscarinic receptors leads to various physiological responses, including increased glandular secretions, smooth muscle contraction, and slowed heart rate. 
  • Increased Stimulation of Nicotinic Receptors: Activating nicotinic receptors stimulates skeletal muscle and autonomic ganglia. In the case of edrophonium, the stimulation of nicotinic receptors is mainly observed at the neuromuscular junction. 

DRUG INTERACTION

edrophonium

&

  • carmellose sodium
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  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
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  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
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  • dienogest/estradiol valerate
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  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
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  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
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  • ibuprofen/dextropropoxyphene
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  • mephenesin
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  • medrysone
  • metixene
  • levobetaxolol
  • guaiacol glycerol ether
  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
  • carbetocin
  • certoparin
  • chlorcyclizine/pseudoephedrine
  • cephapirin
  • indecainide
  • iobitridol
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  • msud analog
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  • iceland moss
  • glutethimide
  • hexachlorophene
  • haloprogin
  • deferoxamine
  • ethchlorvynol
  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
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  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
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  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel oral/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-htp
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
  • clonidine/chlorthalidone
  • captopril/hydrochlorothiazide
  • amlodipine/valsartan/hydrochlorothiazide
  • hydrochlorothiazide and irbesartan
  • candesartan/hydrochlorothiazide
  • ciclesonide intranasal
  • cromolyn sodium ophthalmic
  • methyldopa/hydrochlorothiazide
  • valsartan/hydrochlorothiazide
  • hydrochlorothiazide and triamterene
  • moexipril/hydrochlorothiazide
  • mometasone/intranasal
  • ofloxacin ophthalmic
  • cysteamine
  • metoprolol/hydrochlorothiazide
  • amlodipine/olmesartan
  • eprosartan/hydrochlorothiazide
  • amlodipine/telmisartan
  • hydrochlorothiazide/aliskiren
  • betamethasone/clotrimazole
  • telmisartan/hydrochlorothiazide
  • benazepril/amlodipine
  • bezlotoxumab
  • propranolol/hydrochlorothiazide
  • bupropion/naltrexone
  • burosumab
  • acetylcholine chloride intraocular solution
  • bupivacaine and meloxicam
  • budesonide and formoterol (inhalation)
  • valerian
  • entacapone/levodopa/carbidopa
  • carbidopa/levodopa
  • calaspargase pegol
  • cabotegravir
  • cefixime
  • calfactant
  • brinzolamide
  • daprodustat
  • brimonidine and timolol
  • brodalumab
  • buprenorphine and naloxone
  • hydrocortisone acetic acid otic
  • butorphanol
  • butoconazole
  • adapalene and benzoyl peroxide
  • acrivastine and pseudoephedrine
  • neomycin/polymyxin B/bacitracin topical
  • midodrine
  • baloxavir marboxil
  • bacitracin, neomycin, polymyxin B, and hydrocortisone topical
  • avatrombopag
  • glucagon
  • atenolol/chlorthalidone
  • adefovir
  • activated charcoal
  • avalglucosidase alfa
  • aclidinium and formoterol
  • iclaprim (Pending FDA Approval)
  • ampicillin/sulbactam
  • quinupristin/dalfopristin
  • lamivudine/zidovudine/abacavir
  • acetaminophen and caffeine
  • acetaminophen/pamabrom
  • abacavir and lamivudine
  • anifrolumab
  • elacestrant
  • anidulafungin
  • acetohydroxamic acid
  • alogliptin/pioglitazone
  • anthralin
  • pirtobrutinib
  • gabapentin
  • galsulfase
  • gadoterate meglumine
  • ferric gluconate
  • ferric derisomaltose
  • ethanolamine oleate
  • eteplirsen
  • vasopressin
  • desmopressin
  • meropenem/vaborbactam
  • ecallantide
  • econazole topical
  • dornase alfa
  • aspirin/dipyridamole
  • dipyridamole
  • difenoxin and atropine
  • diflorasone
  • difluprednate ophthalmic
  • eptinezumab
  • diethylpropion
  • dexchlorpheniramine
  • dexmethylphenidate
  • serdexmethylphenidate/​dexmethylphenidate
  • bexagliflozin
  • galcanezumab
  • fremanezumab
  • tapinarof topical
  • darifenacin
  • dalbavancin
  • darbepoetin alfa
  • azilsartan
  • colestipol
  • corticorelin
  • crotamiton
  • crofelemer
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • tapentadol
  • cyclopentolate
  • polymyxin B/bacitracin topical
  • tavaborole
  • tagraxofusp
  • crisaborole
  • crizanlizumab
  • satralizumab
  • spinosad
  • sacubitril/valsartan
  • sargramostim
  • sebelipase alfa
  • regadenoson
  • ribociclib/letrozole
  • ragweed allergen extract
  • radium-223 dichloride
  • secnidazole
  • setmelanotide
  • polycarbophil
  • plecanatide
  • sacituzumab govitecan
  • pertuzumab
  • pertuzumab/trastuzumab/hyaluronidase
  • pamidronate
  • halcinonide
  • glecaprevir/​pibrentasvir
  • glucarpidase
  • golodirsen
  • dextrose (antidote)
  • hexaminolevulinate
  • iohexol
  • ferric citrate
  • elapegademase
  • emicizumab
  • erenumab
  • danaparoid
  • dantrolene
  • eflapegrastim
  • edaravone
  • amcinonide
  • carglumic acid
  • alcaftadine ophthalmic
  • agalsidase beta
  • afamelanotide
  • fosdenopterin
  • lidocaine and chlorhexidine
  • levorphanol
  • calcifediol
  • factor VIIa, recombinant
  • triheptanoin
  • peanut oral allergen powder
  • teprotumumab
  • poly-L-lactic acid/carboxymethylcellulose/mannitol
  • xenon Xe 129 hyperpolarized
  • ublituximab
  • anacaulase
  • glatiramer
  • peginterferon beta-1a
  • interferon beta-1a
  • onabotulinumtoxinA
  • cycloserine
  • ethionamide
  • cabotegravir and rilpivirine
  • vericiguat
  • omidenepag isopropyl
  • azelastine/fluticasone intranasal
edrophonium + 

ceritinib 

may increase the bradycardic effect of Bradycardia-Causing Agents

fingolimod 

may increase the bradycardic effect of Bradycardia-Causing Agents

betamethasone (systemic)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (oral inhalation)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (nasal)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (Topical)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

beclomethasone (nasal)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

trospium

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

procyclidine

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

biperiden

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

benztropine

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

darifenacin hydrobromide

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

thioridazine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

zotepine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

cariprazine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

chlorprothixene

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

lorpiprazole

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

chlorpromazine

it enhance the neurotoxic (central) effect of antipsychotic Agents

haloperidol

it enhance the neurotoxic (central) effect of antipsychotic Agents

pimozide

it enhance the neurotoxic (central) effect of antipsychotic Agents

promazine

it enhance the neurotoxic (central) effect of antipsychotic Agents

zuclopenthixol

it enhance the neurotoxic (central) effect of antipsychotic Agents

amifampridine 

may increase the therapeutic effect of Acetylcholinesterase Inhibitors

neostigmine

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

isoflurophate

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

memantine/donepezil

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

donepezil (Rx)

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

donepezil transdermal

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

propranolol

may increase the bradycardic effect of Acetylcholinesterase Inhibitors

agmatine

may increase the bradycardic effect of each other

mibefradil

may increase the bradycardic effect of each other

donepezil (Rx)

may increase the bradycardic effect of each other

rivastigmine

may increase the bradycardic effect of each other

labetalol 

may increase the bradycardic effect of each other

ouabain

may increase the AV-blocking effect when combined

digitoxin

may increase the AV-blocking effect when combined

digoxin

may increase the AV-blocking effect when combined

pilocarpine

may increase the toxic effect of Acetylcholinesterase Inhibitors

nicotine intranasal

may increase the toxic effect of Acetylcholinesterase Inhibitors

methacholine

may increase the toxic effect of Acetylcholinesterase Inhibitors

carbachol

may increase the toxic effect of Acetylcholinesterase Inhibitors

bethanechol

may increase the toxic effect of Acetylcholinesterase Inhibitors

betamethasone (systemic)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (oral inhalation)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (Topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone dipropionate

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone dipropionate

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

pancuronium

may decrease the neuromuscular-blocking effect when combined

botulinum toxin

may decrease the neuromuscular-blocking effect when combined

abobotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined

rimabotulinumtoxinB

may decrease the neuromuscular-blocking effect when combined

daxibotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined

donepezil

edrophonium: they may increase the bradycardic effect of Bradycardia-Causing Agents

profenamine 

When edrophonium is used together in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine

 

Dosage Forms & Strengths 

Intravenous solution 

2mg 

Intramuscular solution 

10mg 

Myasthenia Gravis 

Initial dose-2mg
If there is a significant improvement after 90 seconds, the test is declared positive and can be discontinued. If the symptoms return, another 2 mg dosage may be given.
If there isn't a noticeable difference after the first dosage, you may give the patient another dose of 3 mg and watch them for another 90 seconds. If the test is negative, give them the last dose of 5 mg and watch them for another three to five minutes.

Assessment of myasthenia gravis therapy needs:
Administer 1 to 2 mg Intravenously given 1 hour after oral anticholinesterase dosage.
Intravenously administer 1 mg; repeat after 1 minute to differentiate cholinergic from myasthenic crises. If the patient is experiencing a cholinergic crisis, intubation, and controlled breathing may be necessary.
Nondepolarizing neuromuscular blockers are reversed.
Administer 0.5 to 1 mg/kg intravenously as the usual dosage.



 

Dosage Forms & Strengths 

Intravenous solution 

0.5mg 

1mg 

2mg 

Intramuscular solution 

2mg 

5mg 

10mg 

Myasthenia Gravis 

Infants-Administer 0.5mg intravenously
Children and Adults:
>34kg- Administer 2 mg. If there is no reaction after 45 seconds, the dose can be increased by 1 mg every 30 to 45 seconds, up to a maximum of 10 mg.
Administer 5mg intramuscularly.
<34 kgs- Administer 1 mg. If there is no reaction after 45 seconds, the dose can be increased by 1 mg every 30 to 45 seconds, up to a maximum of 10 mg.
Administer 2 mg intramuscularly.
Neutralization of nondepolarizing neuromuscular blockers
Usual dose: Administer 0.5 to 1 mg/kg/dose intravenously;
minimum dose: Administer 0.3 mg/kg/dose intravenously



 

Refer adult dosing 

Frequency not defined 

Cardiac arrhythmia 

ECG changes 

Hypotension 

Tachycardia 

Atrioventricular block 

Cardiac arrest 

Flushing 

Syncope 

Thrombophlebitis 

Dizziness 

Dysarthria 

Diarrhea 

Dysphagia 

Urinary urgency 

Weakness 

Diplopia 

Convulsions 

Drowsiness 

Headache 

Flatulence 

Urinary frequency 

Fasciculations 

Conjunctival hyperemia 

Black box warning: 

None 

Contraindications/caution: 

Contraindications: 

  • Hypersensitivity: edrophonium should not be used in individuals with known hypersensitivity or allergic reactions to the drug or its components. 
  • Mechanical obstruction: edrophonium is contraindicated in patients with mechanical gastrointestinal or urinary tract obstruction. It can exacerbate obstruction or increase the risk of complications. 
  • Bradycardia or Heart Block: edrophonium can cause a decrease in heart rate, so it should be used with caution or avoided in patients with bradycardia or heart block. 
  • Asthma or Chronic Obstructive Pulmonary Disease (COPD): edrophonium may cause bronchoconstriction or exacerbate respiratory symptoms in individuals with asthma or COPD.  
  • Epilepsy: edrophonium can lower the seizure threshold and potentially trigger seizures in individuals with a history of epilepsy or seizure disorders. It should be used with caution or avoided in such patients.

Caution: 

  • Cardiac Conditions: edrophonium can cause bradycardia or exacerbate existing cardiac conditions. It should be used cautiously in cardiovascular patients with coronary artery disease, heart failure, or conduction abnormalities. 
  • Respiratory Conditions: edrophonium may cause bronchoconstriction and respiratory distress, particularly in patients with asthma or chronic obstructive pulmonary disease (COPD).  
  • Gastrointestinal Disorders: edrophonium can cause gastrointestinal disturbances such as increased salivation, nausea, vomiting, or diarrhea.  
  • Renal and Hepatic Impairment: There is limited information regarding the use of edrophonium in patients with renal or hepatic impairment. 

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

edrophonium is a short-acting reversible acetylcholinesterase inhibitor with pharmacological properties that involve its interaction with the cholinergic system. 

  • Effects on Cholinergic Transmission: By blocking AChE, edrophonium prolongs the action of ACh at the neuromuscular junction and cholinergic synapses. This leads to increased activation of muscarinic and nicotinic receptors in the cholinergic system. 
  • Muscarinic Receptor Activation: The enhanced cholinergic transmission resulting from increased ACh availability leads to the activation of muscarinic receptors in various organs and tissues. This activation can cause a variety of physiological responses, including increased glandular secretions, smooth muscle contractions, and decreased heart rate. 
  • Nicotinic Receptor Activation: Besides its effects on muscarinic receptors, edrophonium stimulates nicotinic receptors. At the neuromuscular junction, activating nicotinic receptors by ACh leads to muscle contraction, resulting in improved muscle strength. 

Pharmacokinetics: 

Absorption 

edrophonium is typically administered intravenously, which ensures rapid and complete absorption into the bloodstream.  

The Onset of action: 

Intramuscular (IM): 2 to 10 minutes 

Intravenous (IV): 30 to 60 seconds 

Duration: 

Intramuscular: 5 to 30 minutes 

Intravenous: 10 minutes 

Distribution 

edrophonium is distributed throughout the body after intravenous administration. It readily crosses the blood-brain barrier, allowing it to act centrally and peripherally. The extent of protein binding for edrophonium is minimal. 

The volume of distribution (Vd): 

Infants: 1.18 ± 0.2 L/kg 

Children: 1.22 ± 0.74 L/kg 

Adults: 0.9 ± 0.13 L/kg 

 

Metabolism 

edrophonium undergoes minimal metabolism in the body. It is primarily hydrolyzed by cholinesterases, including plasma cholinesterase and acetylcholinesterase, to its inactive metabolites. The metabolism of edrophonium is relatively rapid, leading to its short duration of action.  

Elimination and Excretion 

The elimination of edrophonium and its metabolites occurs primarily through renal excretion. The exact percentage of excretion in urine has not been widely reported. 

Half-life elimination: 

Infants: 73 ± 30 minutes 

Children: 99 ± 31 minutes 

Adults: 126 ± 59 minutes 

Anephric patients: 2.4 to 4.4 hours 

Excretion: 

Adults: Primarily excreted in urine (67%) 

Clearance: 

Infants: 17.8 mL/kg/minute 

Children: 14.2 mL/kg/minute 

Adults: 8.3 ± 2.9 mL/kg/minute 

Administration: 

Intravenous administration 

edrophonium is administered as a slow IV injection over several minutes. The medication should not be administered as a rapid bolus to avoid adverse effects. 

Patient information leaflet 

Generic Name: edrophonium 

Why do we use edrophonium? 

edrophonium is primarily used for diagnostic purposes in evaluating myasthenia gravis, a neuromuscular disorder characterized by muscle weakness and fatigue. The main use of edrophonium is to differentiate between myasthenic and cholinergic crises in patients with myasthenia gravis. Here are the key uses of edrophonium: 

  • Differential Diagnosis of Myasthenia Gravis: edrophonium is administered intravenously to evaluate muscle strength response and symptoms in patients with myasthenia gravis. The temporary improvement in muscle weakness after edrophonium administration suggests a positive response and indicates a myasthenic crisis, where the patient’s symptoms are due to insufficient cholinergic transmission. On the other hand, worsening symptoms may indicate a cholinergic crisis characterized by excessive cholinergic stimulation. 
  • Evaluation of Neuromuscular Junction Function: edrophonium is used to assess the function of the neuromuscular junction, which is the connection between nerves and muscles. By inhibiting acetylcholinesterase, edrophonium increases the concentration of acetylcholine at the neuromuscular junction and temporarily improves muscle strength in patients with myasthenia gravis. 
  • Differentiating Myasthenic Crisis from Cholinergic Crisis: Myasthenic and cholinergic crises are potential complications of myasthenia gravis that can have similar symptoms but require different management approaches. edrophonium administration helps differentiate between these two conditions by observing the patient’s response to the drug. 

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edrophonium

Brand Name :

Enlon-plus, Enlon

Synonyms :

edrophonium

Class :

Antidote; Acetylcholinesterase Inhibitor; Diagnostic Agent




No data available for drug.

Dosage Forms & Strengths 

Intravenous solution 

2mg 

Intramuscular solution 

10mg 

Myasthenia Gravis 

Initial dose-2mg
If there is a significant improvement after 90 seconds, the test is declared positive and can be discontinued. If the symptoms return, another 2 mg dosage may be given.
If there isn't a noticeable difference after the first dosage, you may give the patient another dose of 3 mg and watch them for another 90 seconds. If the test is negative, give them the last dose of 5 mg and watch them for another three to five minutes.

Assessment of myasthenia gravis therapy needs:
Administer 1 to 2 mg Intravenously given 1 hour after oral anticholinesterase dosage.
Intravenously administer 1 mg; repeat after 1 minute to differentiate cholinergic from myasthenic crises. If the patient is experiencing a cholinergic crisis, intubation, and controlled breathing may be necessary.
Nondepolarizing neuromuscular blockers are reversed.
Administer 0.5 to 1 mg/kg intravenously as the usual dosage.



Dosage Forms & Strengths 

Intravenous solution 

0.5mg 

1mg 

2mg 

Intramuscular solution 

2mg 

5mg 

10mg 

Myasthenia Gravis 

Infants-Administer 0.5mg intravenously
Children and Adults:
>34kg- Administer 2 mg. If there is no reaction after 45 seconds, the dose can be increased by 1 mg every 30 to 45 seconds, up to a maximum of 10 mg.
Administer 5mg intramuscularly.
<34 kgs- Administer 1 mg. If there is no reaction after 45 seconds, the dose can be increased by 1 mg every 30 to 45 seconds, up to a maximum of 10 mg.
Administer 2 mg intramuscularly.
Neutralization of nondepolarizing neuromuscular blockers
Usual dose: Administer 0.5 to 1 mg/kg/dose intravenously;
minimum dose: Administer 0.3 mg/kg/dose intravenously



Refer adult dosing 

DRUG INTERACTION

edrophonium

&

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  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
  • technetium Tc-99m disofenin
  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
  • technetium tc-99m medronate
  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel oral/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-htp
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
  • clonidine/chlorthalidone
  • captopril/hydrochlorothiazide
  • amlodipine/valsartan/hydrochlorothiazide
  • hydrochlorothiazide and irbesartan
  • candesartan/hydrochlorothiazide
  • ciclesonide intranasal
  • cromolyn sodium ophthalmic
  • methyldopa/hydrochlorothiazide
  • valsartan/hydrochlorothiazide
  • hydrochlorothiazide and triamterene
  • moexipril/hydrochlorothiazide
  • mometasone/intranasal
  • ofloxacin ophthalmic
  • cysteamine
  • metoprolol/hydrochlorothiazide
  • amlodipine/olmesartan
  • eprosartan/hydrochlorothiazide
  • amlodipine/telmisartan
  • hydrochlorothiazide/aliskiren
  • betamethasone/clotrimazole
  • telmisartan/hydrochlorothiazide
  • benazepril/amlodipine
  • bezlotoxumab
  • propranolol/hydrochlorothiazide
  • bupropion/naltrexone
  • burosumab
  • acetylcholine chloride intraocular solution
  • bupivacaine and meloxicam
  • budesonide and formoterol (inhalation)
  • valerian
  • entacapone/levodopa/carbidopa
  • carbidopa/levodopa
  • calaspargase pegol
  • cabotegravir
  • cefixime
  • calfactant
  • brinzolamide
  • daprodustat
  • brimonidine and timolol
  • brodalumab
  • buprenorphine and naloxone
  • hydrocortisone acetic acid otic
  • butorphanol
  • butoconazole
  • adapalene and benzoyl peroxide
  • acrivastine and pseudoephedrine
  • neomycin/polymyxin B/bacitracin topical
  • midodrine
  • baloxavir marboxil
  • bacitracin, neomycin, polymyxin B, and hydrocortisone topical
  • avatrombopag
  • glucagon
  • atenolol/chlorthalidone
  • adefovir
  • activated charcoal
  • avalglucosidase alfa
  • aclidinium and formoterol
  • iclaprim (Pending FDA Approval)
  • ampicillin/sulbactam
  • quinupristin/dalfopristin
  • lamivudine/zidovudine/abacavir
  • acetaminophen and caffeine
  • acetaminophen/pamabrom
  • abacavir and lamivudine
  • anifrolumab
  • elacestrant
  • anidulafungin
  • acetohydroxamic acid
  • alogliptin/pioglitazone
  • anthralin
  • pirtobrutinib
  • gabapentin
  • galsulfase
  • gadoterate meglumine
  • ferric gluconate
  • ferric derisomaltose
  • ethanolamine oleate
  • eteplirsen
  • vasopressin
  • desmopressin
  • meropenem/vaborbactam
  • ecallantide
  • econazole topical
  • dornase alfa
  • aspirin/dipyridamole
  • dipyridamole
  • difenoxin and atropine
  • diflorasone
  • difluprednate ophthalmic
  • eptinezumab
  • diethylpropion
  • dexchlorpheniramine
  • dexmethylphenidate
  • serdexmethylphenidate/​dexmethylphenidate
  • bexagliflozin
  • galcanezumab
  • fremanezumab
  • tapinarof topical
  • darifenacin
  • dalbavancin
  • darbepoetin alfa
  • azilsartan
  • colestipol
  • corticorelin
  • crotamiton
  • crofelemer
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • tapentadol
  • cyclopentolate
  • polymyxin B/bacitracin topical
  • tavaborole
  • tagraxofusp
  • crisaborole
  • crizanlizumab
  • satralizumab
  • spinosad
  • sacubitril/valsartan
  • sargramostim
  • sebelipase alfa
  • regadenoson
  • ribociclib/letrozole
  • ragweed allergen extract
  • radium-223 dichloride
  • secnidazole
  • setmelanotide
  • polycarbophil
  • plecanatide
  • sacituzumab govitecan
  • pertuzumab
  • pertuzumab/trastuzumab/hyaluronidase
  • pamidronate
  • halcinonide
  • glecaprevir/​pibrentasvir
  • glucarpidase
  • golodirsen
  • dextrose (antidote)
  • hexaminolevulinate
  • iohexol
  • ferric citrate
  • elapegademase
  • emicizumab
  • erenumab
  • danaparoid
  • dantrolene
  • eflapegrastim
  • edaravone
  • amcinonide
  • carglumic acid
  • alcaftadine ophthalmic
  • agalsidase beta
  • afamelanotide
  • fosdenopterin
  • lidocaine and chlorhexidine
  • levorphanol
  • calcifediol
  • factor VIIa, recombinant
  • triheptanoin
  • peanut oral allergen powder
  • teprotumumab
  • poly-L-lactic acid/carboxymethylcellulose/mannitol
  • xenon Xe 129 hyperpolarized
  • ublituximab
  • anacaulase
  • glatiramer
  • peginterferon beta-1a
  • interferon beta-1a
  • onabotulinumtoxinA
  • cycloserine
  • ethionamide
  • cabotegravir and rilpivirine
  • vericiguat
  • omidenepag isopropyl
  • azelastine/fluticasone intranasal
edrophonium + 

ceritinib 

may increase the bradycardic effect of Bradycardia-Causing Agents

fingolimod 

may increase the bradycardic effect of Bradycardia-Causing Agents

betamethasone (systemic)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (oral inhalation)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (nasal)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

budesonide (Topical)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

beclomethasone (nasal)

corticosteroids may increase the risk of adverse effects of acetylcholinesterase Inhibitors

trospium

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

procyclidine

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

biperiden

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

benztropine

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

darifenacin hydrobromide

acetylcholinesterase Inhibitors may diminish the therapeutic effect of anticholinergic Agents

thioridazine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

zotepine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

cariprazine

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

chlorprothixene

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

lorpiprazole

acetylcholinesterase Inhibitors may enhance the neurotoxic (central) effect of antipsychotic Agents

chlorpromazine

it enhance the neurotoxic (central) effect of antipsychotic Agents

haloperidol

it enhance the neurotoxic (central) effect of antipsychotic Agents

pimozide

it enhance the neurotoxic (central) effect of antipsychotic Agents

promazine

it enhance the neurotoxic (central) effect of antipsychotic Agents

zuclopenthixol

it enhance the neurotoxic (central) effect of antipsychotic Agents

amifampridine 

may increase the therapeutic effect of Acetylcholinesterase Inhibitors

neostigmine

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

isoflurophate

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

memantine/donepezil

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

donepezil (Rx)

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

donepezil transdermal

may diminish the therapeutic effect of Acetylcholinesterase Inhibitors

propranolol

may increase the bradycardic effect of Acetylcholinesterase Inhibitors

agmatine

may increase the bradycardic effect of each other

mibefradil

may increase the bradycardic effect of each other

donepezil (Rx)

may increase the bradycardic effect of each other

rivastigmine

may increase the bradycardic effect of each other

labetalol 

may increase the bradycardic effect of each other

ouabain

may increase the AV-blocking effect when combined

digitoxin

may increase the AV-blocking effect when combined

digoxin

may increase the AV-blocking effect when combined

pilocarpine

may increase the toxic effect of Acetylcholinesterase Inhibitors

nicotine intranasal

may increase the toxic effect of Acetylcholinesterase Inhibitors

methacholine

may increase the toxic effect of Acetylcholinesterase Inhibitors

carbachol

may increase the toxic effect of Acetylcholinesterase Inhibitors

bethanechol

may increase the toxic effect of Acetylcholinesterase Inhibitors

betamethasone (systemic)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (oral inhalation)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

budesonide (Topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone dipropionate

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (topical)

may increase the toxic effect of Acetylcholinesterase Inhibitors

beclomethasone dipropionate

may increase the toxic effect of Acetylcholinesterase Inhibitors

fluticasone (nasal)

may increase the toxic effect of Acetylcholinesterase Inhibitors

pancuronium

may decrease the neuromuscular-blocking effect when combined

botulinum toxin

may decrease the neuromuscular-blocking effect when combined

abobotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined

rimabotulinumtoxinB

may decrease the neuromuscular-blocking effect when combined

daxibotulinumtoxinA

may decrease the neuromuscular-blocking effect when combined

donepezil

edrophonium: they may increase the bradycardic effect of Bradycardia-Causing Agents

profenamine 

When edrophonium is used together in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine

Actions and Spectrum: 

The mechanism of action of edrophonium involves the following steps: 

  • Inhibition of Acetylcholinesterase: edrophonium binds to and inhibits acetylcholinesterase, which breaks down acetylcholine in the synaptic cleft. By inhibiting AChE, edrophonium prevents the rapid breakdown of acetylcholine, leading to an increased concentration of acetylcholine in the synapse. 
  • Enhanced Cholinergic Transmission: The increased concentration of acetylcholine in the synapse prolongs the interaction of acetylcholine with postsynaptic cholinergic receptors. This enhances cholinergic transmission and promotes the activation of muscarinic and nicotinic receptors. 
  • Increased Stimulation of Muscarinic Receptors: The activation of muscarinic receptors leads to various physiological responses, including increased glandular secretions, smooth muscle contraction, and slowed heart rate. 
  • Increased Stimulation of Nicotinic Receptors: Activating nicotinic receptors stimulates skeletal muscle and autonomic ganglia. In the case of edrophonium, the stimulation of nicotinic receptors is mainly observed at the neuromuscular junction. 

Frequency not defined 

Cardiac arrhythmia 

ECG changes 

Hypotension 

Tachycardia 

Atrioventricular block 

Cardiac arrest 

Flushing 

Syncope 

Thrombophlebitis 

Dizziness 

Dysarthria 

Diarrhea 

Dysphagia 

Urinary urgency 

Weakness 

Diplopia 

Convulsions 

Drowsiness 

Headache 

Flatulence 

Urinary frequency 

Fasciculations 

Conjunctival hyperemia 

Black box warning: 

None 

Contraindications/caution: 

Contraindications: 

  • Hypersensitivity: edrophonium should not be used in individuals with known hypersensitivity or allergic reactions to the drug or its components. 
  • Mechanical obstruction: edrophonium is contraindicated in patients with mechanical gastrointestinal or urinary tract obstruction. It can exacerbate obstruction or increase the risk of complications. 
  • Bradycardia or Heart Block: edrophonium can cause a decrease in heart rate, so it should be used with caution or avoided in patients with bradycardia or heart block. 
  • Asthma or Chronic Obstructive Pulmonary Disease (COPD): edrophonium may cause bronchoconstriction or exacerbate respiratory symptoms in individuals with asthma or COPD.  
  • Epilepsy: edrophonium can lower the seizure threshold and potentially trigger seizures in individuals with a history of epilepsy or seizure disorders. It should be used with caution or avoided in such patients.

Caution: 

  • Cardiac Conditions: edrophonium can cause bradycardia or exacerbate existing cardiac conditions. It should be used cautiously in cardiovascular patients with coronary artery disease, heart failure, or conduction abnormalities. 
  • Respiratory Conditions: edrophonium may cause bronchoconstriction and respiratory distress, particularly in patients with asthma or chronic obstructive pulmonary disease (COPD).  
  • Gastrointestinal Disorders: edrophonium can cause gastrointestinal disturbances such as increased salivation, nausea, vomiting, or diarrhea.  
  • Renal and Hepatic Impairment: There is limited information regarding the use of edrophonium in patients with renal or hepatic impairment. 

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

edrophonium is a short-acting reversible acetylcholinesterase inhibitor with pharmacological properties that involve its interaction with the cholinergic system. 

  • Effects on Cholinergic Transmission: By blocking AChE, edrophonium prolongs the action of ACh at the neuromuscular junction and cholinergic synapses. This leads to increased activation of muscarinic and nicotinic receptors in the cholinergic system. 
  • Muscarinic Receptor Activation: The enhanced cholinergic transmission resulting from increased ACh availability leads to the activation of muscarinic receptors in various organs and tissues. This activation can cause a variety of physiological responses, including increased glandular secretions, smooth muscle contractions, and decreased heart rate. 
  • Nicotinic Receptor Activation: Besides its effects on muscarinic receptors, edrophonium stimulates nicotinic receptors. At the neuromuscular junction, activating nicotinic receptors by ACh leads to muscle contraction, resulting in improved muscle strength. 

Pharmacokinetics: 

Absorption 

edrophonium is typically administered intravenously, which ensures rapid and complete absorption into the bloodstream.  

The Onset of action: 

Intramuscular (IM): 2 to 10 minutes 

Intravenous (IV): 30 to 60 seconds 

Duration: 

Intramuscular: 5 to 30 minutes 

Intravenous: 10 minutes 

Distribution 

edrophonium is distributed throughout the body after intravenous administration. It readily crosses the blood-brain barrier, allowing it to act centrally and peripherally. The extent of protein binding for edrophonium is minimal. 

The volume of distribution (Vd): 

Infants: 1.18 ± 0.2 L/kg 

Children: 1.22 ± 0.74 L/kg 

Adults: 0.9 ± 0.13 L/kg 

 

Metabolism 

edrophonium undergoes minimal metabolism in the body. It is primarily hydrolyzed by cholinesterases, including plasma cholinesterase and acetylcholinesterase, to its inactive metabolites. The metabolism of edrophonium is relatively rapid, leading to its short duration of action.  

Elimination and Excretion 

The elimination of edrophonium and its metabolites occurs primarily through renal excretion. The exact percentage of excretion in urine has not been widely reported. 

Half-life elimination: 

Infants: 73 ± 30 minutes 

Children: 99 ± 31 minutes 

Adults: 126 ± 59 minutes 

Anephric patients: 2.4 to 4.4 hours 

Excretion: 

Adults: Primarily excreted in urine (67%) 

Clearance: 

Infants: 17.8 mL/kg/minute 

Children: 14.2 mL/kg/minute 

Adults: 8.3 ± 2.9 mL/kg/minute 

Administration: 

Intravenous administration 

edrophonium is administered as a slow IV injection over several minutes. The medication should not be administered as a rapid bolus to avoid adverse effects. 

Patient information leaflet 

Generic Name: edrophonium 

Why do we use edrophonium? 

edrophonium is primarily used for diagnostic purposes in evaluating myasthenia gravis, a neuromuscular disorder characterized by muscle weakness and fatigue. The main use of edrophonium is to differentiate between myasthenic and cholinergic crises in patients with myasthenia gravis. Here are the key uses of edrophonium: 

  • Differential Diagnosis of Myasthenia Gravis: edrophonium is administered intravenously to evaluate muscle strength response and symptoms in patients with myasthenia gravis. The temporary improvement in muscle weakness after edrophonium administration suggests a positive response and indicates a myasthenic crisis, where the patient’s symptoms are due to insufficient cholinergic transmission. On the other hand, worsening symptoms may indicate a cholinergic crisis characterized by excessive cholinergic stimulation. 
  • Evaluation of Neuromuscular Junction Function: edrophonium is used to assess the function of the neuromuscular junction, which is the connection between nerves and muscles. By inhibiting acetylcholinesterase, edrophonium increases the concentration of acetylcholine at the neuromuscular junction and temporarily improves muscle strength in patients with myasthenia gravis. 
  • Differentiating Myasthenic Crisis from Cholinergic Crisis: Myasthenic and cholinergic crises are potential complications of myasthenia gravis that can have similar symptoms but require different management approaches. edrophonium administration helps differentiate between these two conditions by observing the patient’s response to the drug.