Muscarinic symptoms (nausea, vomiting, diarrhea, sweating, increased bronchial and salivary secretions and bradycardia) may appear with overdosage (cholinergic crisis) of ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection, but may be managed by the use of additional atropine sulfate. Obstruction of the airway by bronchial secretions can arise and may be managed with suction (especially if tracheostomy has been performed).

Should edrophonium chloride overdosage occur:

1. Maintain respiratory exchange.

2. Monitor cardiac function.

Appropriate measures should be taken if convulsions occur or shock is present.

Principal manifestations of overdosage (poisoning) with atropine sulfate are delirium, tachycardia and fever. In the treatment of atropine poisoning, respiratory assistance and symptomatic support are indicated. Death is usually due to paralysis of the medullary centers.

In the clinical studies performed with ENLON-PLUS, there were no reported overdoses and therefore no clinical information is available regarding overdosing with ENLON-PLUS.

ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection is not to be used in patients with known hypersensitivity to either of the components, or in patients with intestinal or urinary obstruction of mechanical type. Atropine sulfate is contraindicated in the presence of acute glaucoma, adhesions (synechiae) between the iris and lens of the eye, and pyloric stenosis.

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