Guanethidine monosulphate

CLINICAL USE

Treatment of hypertensive crisis

DOSE IN NORMAL RENAL FUNCTION

  • 10 to 20     : mg, repeated after 3 hours if required

    PHARMACOKINETICS

  • Molecular weight                           :296.4
  • %Protein binding                           :<5
  • %Excreted unchanged in urine     : 25–60
  • Volume of distribution (L/kg)       :Large
  • half-life – normal/ESRD (hrs)      :120–240/increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Give every 24 hours
  • 10 to 20     : Give every 24 hours
  • <10           : Give every 24–36 hours; use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Likely dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Anaesthetics: enhanced hypotensive effect
  • Sympathomimetics: hypotensive effect antagonised by ephedrine, isometheptene, metaraminol, methylphenidate, noradrenaline, oxymetazoline, phenylephrine, phenylpropanolamine, pseudoephedrine and xylometazoline

    ADMINISTRATION

    Reconstition

    –

    Route

    IM

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Blood pressure should fall within 30 minutes of dose

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