| AMBENONIUM CHLORIDE
Classifications: cholinesterase inhibitor; Therapeutic: cholinesterase inhibitor
Pregnancy Category: C
10 mg tablets
Inhibits destruction of acetylcholine (ACh) by cholinesterase, thereby prolonging effects of ACh (neurotransmitter) at postsynaptic
receptor sites. Has direct stimulant effect on striated muscles.
Improves muscular strength in myasthenia gravis.
Symptomatic treatment of myasthenia gravis for patients who cannot tolerate neostigmine bromide or pyridostigmine bromide
because of bromide sensitivity. Has been used in conjunction with corticosteroids, ephedrine sulfate, and potassium chloride
to increase muscle strength.
Intestinal or urinary tract obstruction; patients receiving mecamylamine; pregnancy (category C); lactation.
Epilepsy, bradycardia, cardiac arrhythmias, recent coronary occlusion; bronchial asthma; hyperthyroidism; older adults;
vagotonia; peptic ulcer, megacolon.
Route & Dosage
Adult: PO 2.55 mg t.i.d. or q.i.d., may increase q12d to 5075 mg t.i.d. or q.i.d. if necessary
Child: PO 0.3 mg/kg/d in 34 divided doses, may need up to 1.5 mg/kg/d in 34 divided doses
- Give with food or milk to minimize adverse effects.
- Schedule larger doses when patient experiences the most fatigue or muscle weakness; to improve ability to eat, give drug
3045 min before meals.
- Store at 15°30° C (59°86° F) unless otherwise directed.
Adverse Effects (≥1%)CNS:
Exaggerated cholinergic (muscarinic) effects; muscle cramps, headache, confusion, dizziness, incoordination, fasciculations,
agitation, restlessness, muscle weakness, paralysis,
slurred speech, convulsions, respiratory depression. CV:
Nausea, vomiting, diarrhea
, abdominal cramps, excessive salivation. Special Senses:
Blurred vision, lacrimation. Respiratory: Bronchospasm,
increased bronchial secretions, dyspnea
and other cholinesterase inhibitors
possibly compound toxicity
; mecamylamine, succinylcholine, procainamide, quinidine, aminoglycosides
increase neuromuscular blocking effects with possibility of respiratory depression; atropine antagonizes effects of ambenonium.
Poorly absorbed from GI tract. Onset:
2030 min. Duration:
Assessment & Drug Effects
- Therapeutic effect may not be apparent for several days after initiation of therapy.
- Keep atropine sulfate immediately available to treat severe cholinergic reactions.
- Monitor for S&S of overdosage (muscle weakness within 1 h; headache, weakness of muscles of neck, chewing, and swallowing,
increased salivation) and inadequate ventilation (unusual apprehension, restlessness, rapid pulse and respirations, rising
- Monitor vital signs during dosage adjustment periods.
- Note: Muscle weakness beginning 3 h or more after drug administration is probably due to underdosage or drug resistance.
Patient & Family Education
- Follow directions for taking this drug (see ADMINISTRATION).
- Learn to recognize adverse effects, how to modify the doses accordingly, and when to take atropine.
- Note: During long-term therapy the drug may become ineffective; responsiveness usually returns when dosage is reduced or drug is
withdrawn for several days.
- Carry medical identification indicating medical diagnosis and medication(s) being taken.