Edrophonium - source? Price?

Re: Edrophonium - source? Price?

Mark Lowrie — Wed, 12 Oct 2011 19:13:50 GMT

We haven't been able to get hold of edrophonium for some time now so unfortunately we have to rely on ACh AB serology, clinical signs and response to longer acting AChesterase inhibitors. I agree with the fact that prognosis is poor as your patient has megaoesophagus, is a Boxer (not a disease intself, but close...) and is severely affected. If chest rads do not show a thymoma then starting pyridostigmine (60 mg) tablets at very low end of dose range e.g. 7.5mg (1/8th tablet) BID and increasing slowly every 24h to effect would be best approach. The trouble is overdose is v easy to do and shows the same clinical signs as under-dosing. Not the easiest disease to treat....

Re: Edrophonium - source? Price?

Stephen Courtney — Tue, 11 Oct 2011 20:59:01 GMT

^^^ doesn't sound promising. There is little point worrying about any of this if the owners can't pill their own dog, and if he has megaoesophagus how long before aspiration pneumonia...

Re: Edrophonium - source? Price?

Anonymous — Tue, 11 Oct 2011 16:46:52 GMT

Thanks very much for replies and suggestions. ACh Rec Abs test in post, but lab (Axiom) say up to 10 days for result.

No joy at all trying to source edrophonium at all (Dublin vet school are only place on island of Ireland I've identified to have it, but can't post it and owners unable to take dog there).

Have pyridostigmine and probably would try trial dose orally, but dog is aggressive (though if exercised very weak allowing radiographs )and I certainly can't tablet it - owners are going to try, but is largely anorexic with megaoesophagus and extremely weak with difficulty rising, so any oral meds could be tricky. Also bit concerned re side effects if not myasthenia gravis in this dog (hence wanting to do test first), having said that, can't think of much else that might be treatable, so probably worth a shot...

Re: Edrophonium - source? Price?

Andrew Kent — Tue, 11 Oct 2011 16:09:34 GMT

It is pretty much unavailable now, I haven't managed to find a source for last couple of years. I believe this is because it is no longer used in human medicine and for vets has been largely replaced by antibody testing.

In emergencies if I have a high clinical suspicion I have had to resort to assessment of response to pyridostigmine instead.

Andy

Re: Edrophonium - source? Price?

Helen Wallace — Tue, 11 Oct 2011 15:54:22 GMT

Have got it from Dunlops in the past. I suspect a hospital pharmacy is your best option. Can't remeber the exact price- I think it cost around £80 for 5 vials to the client (we charged for the lot as we don't do often enough to use the rest). Did respond very nicely and gave us a quick diagnosis. The antibody test would have taken around 2 weeks for results then. Patient still doing well on mestinon.

Re: Edrophonium - source? Price?

Michael Woodhouse — Tue, 11 Oct 2011 13:28:10 GMT

It's listed in the BNF - expect local pharmacy (or hospital pharmacy) would be my best guess.