ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection is recommended as a reversal agent or antagonist of nondepolarizing neuromuscular blocking agents. It is not effective against depolarizing neuromuscular blocking agents. It is also useful if used adjunctively in the treatment of respiratory depression caused by curare overdosage.

The appropriateness of the specific fixed ratio of edrophonium and atropine contained in ENLON-PLUS has not been evaluated in myasthenia gravis. Therefore, ENLON-PLUS is not recommended for use in the differential diagnosis of this condition.

Dosages of ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection range from 0.05-0.1 mL/kg given slowly over 45 seconds to 1 minute at a point of at least 5% recovery of twitch response to neuromuscular stimulation (95% block). The dosage delivered is 0.5-1.0 mg/kg of edrophonium chloride and 0.007-0.014 mg/kg of atropine sulfate. A total dosage of 1.0 mg/kg of edrophonium chloride should rarely be exceeded. Response should be monitored carefully and assisted or controlled ventilation secured. Satisfactory reversal permits adequate voluntary respiration and neuromuscular transmission (as tested with a peripheral nerve stimulator). Recurarization has not been reported after satisfactory reversal has been attained.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.

Storage

REFERENCES

5. Fisher DM, Cronnelly R, Sharma M, Miller RD: Clinical pharmacology of edrophonium in infants and children. Anesthesiology 1984; 61:428-433.

6. Silverberg PA, Matteo RS, Ornstein E, Young WL, Diaz J: Pharmacokinetics and pharmacodynamics of edrophonium in the elderly. Anesth Analg 1986;65:S142.

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