Amifampridine, as a specific therapeutic drug for Lambert Eaton myasthenia gravis syndrome, requires strict adherence to key aspects such as dosage adjustment, adverse reaction monitoring, contraindications, and drug interactions to ensure medication safety.

Dosage and administration plan

The initial dosage is recommended to be 15-30mg/day, divided into 3-4 oral doses, gradually increasing according to clinical response. The maximum daily dose should not exceed 80mg, and individualized reduction is required for patients with renal insufficiency. If the missed dose is close to the next administration time, it should be skipped and double dose supplementation is prohibited.

2. Key points of adverse reaction monitoring

Regular monitoring of electrocardiogram (focusing on QT interval), renal function, and neurological symptoms is required during treatment. Immediate medical attention should be sought if abnormal sensations worsen, seizures occur, or arrhythmia occur. Common side effects such as dizziness and nausea are mostly transient, and taking them with meals can alleviate gastrointestinal reactions.

3 Absolute Contraindications

Patients with a history of epilepsy should avoid using it (which may lower the seizure threshold). Severe renal insufficiency (eGFR<30mL/min) is contraindicated. Pregnant women are prohibited from using contraception (as shown to be teratogenic in animals), and women of childbearing age should take effective contraceptive measures until at least 48 hours after discontinuing the medication.

4 Important Drug Interactions

Avoid using other QT interval prolonging drugs in combination (such as antiarrhythmic drugs). CYP3A4 strong inhibitors (such as clarithromycin) may increase blood drug concentrations and require dosage adjustment. Smoking may reduce efficacy, it is recommended to quit smoking during treatment.

Medication for 5 special populations

Breastfeeding should be suspended during the medication period for lactating women. Elderly patients should be cautious when titrating their dosage. The safety of pediatric medication has not been established and is not recommended for use. Patients with liver dysfunction do not need to adjust the dosage, but need to strengthen monitoring.

6 Storage and administration requirements

Tablets should be swallowed whole and should not be broken or chewed. The original packaging should be stored in the dark below 25 ℃ to avoid moisture. Expired or remaining drugs should be disposed of through professional channels to prevent accidental ingestion.