Low-dose guanidine and pyridostigmine: relatively safe and effective long-term symptomatic therapy in Lambert-Eaton myasthenic syndrome.

Guanidine hydrochloride is known to be highly effective in the symptomatic treatment of the Lambert-Eaton myasthenic syndrome (LEMS). However, because of its potentially dangerous side reactions of hematologic abnormalities and renal insufficiency, 3,4-diaminopyridine, which is not readily available in the United States, is recommended as the preferred drug for LEMS. We used low-dose guanidine and pyridostigmine combination therapy in 9 patients with LEMS and analyzed its long-term safety and effectiveness. In all patients, a liberal amount of pyridostigmine was used, while daily guanidine dose was kept below 1000 mg a day, and guanidine was given between pyridostigmine dosings. This combination therapy was used for 3-102 months (mean: 34.1 months) and improved clinical status in all patients. Although guanidine had to be discontinued due to severe gastrointestinal symptoms in 3 cases, no serious side reactions such as bone marrow suppressions or signs of renal insufficiency developed in any case. Thus, we conclude that low-dose guanidine therapy is relatively safe and effective for long-term symptomatic treatment of LEMS when it is combined with pyridostigmine.
AuthorsS J Oh, D S Kim, T C Head, G C Claussen
JournalMuscle & nerve (Muscle Nerve) Vol. 20 Issue 9 Pg. 1146-52 (Sep 1997) ISSN: 0148-639X [Print] UNITED STATES
PMID9270671 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Cholinesterase Inhibitors
  • Guanidines
  • Guanidine
  • Pyridostigmine Bromide
  • Adult
  • Aged
  • Cholinesterase Inhibitors (administration & dosage, adverse effects, therapeutic use)
  • Dose-Response Relationship, Drug
  • Electrophysiology
  • Female
  • Guanidine
  • Guanidines (administration & dosage, adverse effects, therapeutic use)
  • Humans
  • Lambert-Eaton Myasthenic Syndrome (complications, drug therapy, physiopathology)
  • Male
  • Middle Aged
  • Neoplasms (complications, therapy)
  • Pyridostigmine Bromide (administration & dosage, adverse effects, therapeutic use)
  • Time Factors
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: