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

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Route

Rate of Administration

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Comments

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OTHER INFORMATION

Blood pressure should fall within 30 minutes of dose

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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