Parenteral Manual

Edrophonium chloride

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Alternate Name(s): 
Diagnostic agent for myasthenia gravis; parasympathomimetic to reverse curariform drugs
Original Date: 
August 2005
  • Differential diagnosis of myasthenia gravis, evaluation of treatment of myasthenia gravis
  • Curare antagonist for reversal of neuromuscular blockade produced by tubocurarine, curare, gallamine triethiodide, atracurium, vecuronium, pancuronium
  • Treatment of respiratory depression caused by curare overdose
Reconstitution and Stability: 
  • Stable at room temperature
  • Protect from light
  • Available as 10 mg/mL ampoules and multi-dose vials

- Solutions Compatible: D5W, 0.9% NaCl, D5NS, ringer's lactate for 4 hours at room temperature

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: KCl (up to 40 mEq/L), heparin

Incompatible: no information


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC YES, usually IV
IM YES, usually IV
IV Push

Usual dilution: undiluted
Infusion: 1 minute

IV Intermittant Infusion NO
IV Continuous Infusion NO

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

- Myasthenia gravis diagnosis:

  • 0.5-1 mg IM/SC OR
  • 0.1 mg IV followed by 0.4 mg (if no response): total dose = 0.5 mg

- Myasthenia gravis diagnosis:

  • <34 kg: 2 mg IM/SC  
  • >34 kg: 5 mg IM/SC OR
  • 0.04 mg/kg IV followed by 0.16 mg/kg IV given within 45 seconds, if no response   
  • Maximum: 10 mg total

Adolescent/Adult :            
- Myasthenia gravis diagnosis:

  • 10 mg IM/SC: if no cholinergic reaction occurs, give 2 mg 30 minutes later to rule out false    negative OR
  • Use 10 mg in tuberculin syringe, 2 mg test dose administered over 15-30 seconds leaving needle in situ; If no reaction in 45 seconds, inject remaining 8 mg.  May repeat in 30 minutes

- Curare antagonist:

  • 10 mg IV over 30-45 seconds.  May repeat Q 5-10 minutes
  • Maximum: 40 mg total dose
Potential hazards of parenteral administration: 
  • Thrombophlebitis
  • Bradycardia and cardiac arrhythmias (antidote-atropine sulphate), A-V block
  • Hypotension
  • Bronchospasm, respiratory distress especially in asthmatics
  • Increased salivary, gastrointestinal, lacrimal and bronchial secretions
  • Weakness and fasciculations
  • Seizures, drowsiness, headaches


  • May cause cholinergic crisis (IV atropine should be available)
  • Resuscitation equipment should be readily available
  • Not effective in reversing paralysis caused by succinylcholine
  • Caution in patients with asthma or cardiac arrhythmias
  • Supportive ventilation must be readily available in apneic patients
  • Not recommended for maintenance therapy in myasthenia gravis due to short duration of action
  • Contraindicated in intestinal and urinary obstruction of mechanical type
  • Monitor pre- and post-injection strength, heart rate, respiratory rate, blood pressure, changes in fasciculations
  • Dose may need to be reduced in chronic renal failure


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