Pyridostigmine, Pyridostigmine ER
Generic Regonol, Mestinon
- Generic
- • Tablet
- • 60mg
- • 90 Tablets
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Intro
Introduction
Written by Alex Brewer, PharmD, MBA
Medically reviewed by Amber Watson, PharmD
Updated on October 3, 2023
Pyridostigmine (peer id oh STIG meen) is a generic medication prescribed to adults for treating myasthenia gravis. Pyridostigmine belongs to a group of drugs called cholinesterase inhibitors.
This article doesn’t provide coupons for all forms of pyridostigmine. To find coupons for pyridostigmine extended-release oral tablet, see this article.
Side effects
Side effects of pyridostigmine
Pyridostigmine may cause mild or serious side effects. More common mild side effects of pyridostigmine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.
To learn more about pyridostigmine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for pyridostigmine listed in the “Resources” section.
Mild side effects
More common mild side effects reported with pyridostigmine are listed below.
This article doesn’t include all possible mild side effects of the drug. To learn more about pyridostigmine’s side effects, refer to the prescribing information for pyridostigmine listed in the “Resources” section.
With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.
Pyridostigmine oral tablet, oral extended-release (ER) tablet, and oral solution’s mild side effects include:
- nausea and vomiting
- diarrhea
- cramps, such as in your abdomen or muscles
- increased saliva production
- mild allergic reaction*
* For details about this side effect, see the “Interactions and warnings for pyridostigmine” section.
Serious side effects
Serious side effects of pyridostigmine are listed below.
This article doesn’t include all possible serious side effects of the drug. To learn more about pyridostigmine’s side effects, refer to the prescribing information for pyridostigmine listed in the “Resources” section.
With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.
In general, pyridostigmine’s serious side effects include:
- cholinergic crisis (a serious condition caused by having too much of a chemical messenger called acetylcholine in your system)
- severe allergic reaction*
* For details about this side effect, see the “Interactions and warnings for pyridostigmine” section.
FAQ
Common questions about pyridostigmine
Below you’ll find answers to a few commonly asked questions about pyridostigmine.
What is pyridostigmine’s mechanism of action? How does the drug work?
Pyridostigmine works to treat myasthenia gravis by blocking the action of an enzyme called cholinesterase.
An enzyme is a type of protein that speeds up reactions in the body. Cholinesterase is an enzyme that breaks down a chemical messenger called acetylcholine. Acetylcholine is important for many body functions, including helping your muscles contract. Muscle weakness as a symptom of myasthenia gravis happens because the immune system is not allowing acetylcholine to function properly. Pyridostigmine works by increasing the amount of acetylcholine in your system. More acetylcholine in your system means it’s easier for your muscles to contract despite the changes caused by myasthenia gravis.
Pyridostigmine begins working with your first dose, but it may take up to several weeks for your symptoms to improve.
If you’d like to know more about this, talk with your doctor or pharmacist.
What brand names are available for pyridostigmine?
Pyridostigmine is available as the brand-name product Mestinon. Like pyridostigmine, Mestinon is available as an oral tablet, oral extended-release tablet, and oral solution.
Pyridostigmine also comes as a brand-name injection called Regonol. But the injection form is not available as a generic.
A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.
Talk with your doctor or pharmacist if you’d like to learn more about brand names for pyridostigmine.
Uses
Uses of pyridostigmine
The Food and Drug Administration (FDA) approves prescription drugs such as pyridostigmine for certain conditions. Approved uses for pyridostigmine are described below.
Use for myasthenia gravis
Doctors may prescribe pyridostigmine for treating myasthenia gravis. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.
With myasthenia gravis, nerve signals between the brain and muscles are blocked. This leads to symptoms including muscle weakness. Other symptoms vary depending on the affected muscles. For example, myasthenia gravis that affects the throat can cause difficulty speaking or swallowing. And myasthenia gravis that affects the arms and legs can cause weakness and problems walking.
Interactions and warnings
Interactions and warnings for pyridostigmine
Below, you’ll find information about pyridostigmine’s possible interactions and warnings.
Interactions of pyridostigmine
Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.
Before you take pyridostigmine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:
- prescription or over-the-counter drugs
- vitamins, herbs, or supplements
To learn about drug-condition interactions, see the “Warnings for pyridostigmine” section below.
Warnings for pyridostigmine
Some people should not take pyridostigmine, and others should use it cautiously.
Pyridostigmine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether pyridostigmine is a safe option for you.
Ask your doctor about specific warnings for pyridostigmine, and be sure to tell your doctor about your:
- current health, including any allergies to medications
- past health conditions or surgeries
Allergic reaction
Pyridostigmine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.
If you’ve had an allergic reaction to pyridostigmine or any of its ingredients, your doctor will likely not prescribe pyridostigmine. They can tell you about medications that are safer options for you.
A mild allergic reaction may cause the following symptoms:
A severe allergic reaction may cause the following symptoms:
- swelling under your skin, usually in your hands, feet, eyelids, or lips
- swelling of your mouth, throat, or tongue, which can cause breathing problems
If you have an allergic reaction to pyridostigmine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.
Overdose of pyridostigmine
You should not take more pyridostigmine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.
If you think you’ve taken too much pyridostigmine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Pregnancy or breastfeeding and pyridostigmine
Information about pyridostigmine and pregnancy and breastfeeding is described below.
Pyridostigmine and pregnancy
It’s not known whether pyridostigmine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.
Pyridostigmine and breastfeeding
It’s not known whether pyridostigmine should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.
Ask your doctor
What to ask your doctor
Let your doctor know if you have questions about pyridostigmine or would like more details about it.
Here’s a list of some possible questions you may want to ask your doctor:
- How does pyridostigmine compare to other treatments for myasthenia gravis?
- How will we monitor whether pyridostigmine is working for me?
- If pyridostigmine interacts with a medication I take or my health history, can you prescribe a lower dosage for me to try?
- Is one form of pyridostigmine a better option for me than others, based on my health history?
Resources
Resources
- Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
- Pyridostigmine bromide- pyridostigmine bromide solution. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/0d642561-8ade-460b-b6b0-78cfc6cc2694/spl-doc
- Pyridostigmine bromide- pyridostigmine bromide tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/30cb0b9f-e308-4501-90c2-b17349c048b7/spl-doc
- Pyridostigmine bromide- pyridostigmine bromide tablet, extended release. (2021). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/901ade23-0893-7fad-e053-2a95a90a09a8/spl-doc
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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