Pyridostigmine

Description

Pyridostigmine is a medication primarily used to treat myasthenia gravis, a neuromuscular disorder characterized by weakness and rapid fatigue of voluntary muscles. It acts as a reversible inhibitor of the enzyme acetylcholinesterase, which increases the levels of acetylcholine in the body, enhancing communication between nerves and muscles.

Uses / Indications

• Myasthenia gravis
• Reversal of neuromuscular blockade in surgical settings
• Treatment of certain cases of dry mouth (xerostomia)
• Off-label use for postural orthostatic tachycardia syndrome (POTS)
• Management of muscle weakness in conditions involving impaired neuromuscular transmission

Dosage and Administration

Adults:
Initial dose typically ranges from 60 mg to 150 mg per day, divided into multiple doses (adjusted based on clinical response).

Children (age and weight-based dosing):
Dosing should be determined by a healthcare provider, typically starting at lower doses and titrating as needed for effectiveness.

Note: Dosage may vary based on medical condition or doctor’s advice.

How It Works (Mechanism of Action)

Pyridostigmine works by inhibiting acetylcholinesterase, which leads to an accumulation of acetylcholine at the neuromuscular junction. This improves communication between nerve and muscle cells, thereby enhancing the ability to contract muscles and improving muscle strength in patients with myasthenia gravis.

Side Effects

Common side effects:

• Nausea
• Diarrhea
• Abdominal cramps
• Increased salivation
• Sweating

Rare/serious side effects:

• Severe abdominal pain
• Respiratory distress
• Allergic reactions (rash, itching, swelling)

Seek medical attention if serious side effects occur.

Precautions / Warnings

• Tell your doctor if you have asthma, heart disease, or a history of seizures.
• Use caution if combining with other medications that affect muscle function.
• Regular monitoring of muscle strength may be necessary.

Drug Interactions

May interact with:

• Other cholinesterase inhibitors
• Medications that affect heart rate (e.g., beta blockers)
• Certain antibiotics (e.g., aminoglycosides)
• Anticholinergic drugs

Always inform your healthcare provider about any other medications, supplements, or health conditions.

Storage Instructions

• Store at room temperature (15°C–30°C / 59°F–86°F)
• Keep away from moisture, heat, and direct light
• Keep out of reach of children

Missed Dose / Overdose

Missed a dose?
Take it as soon as you remember. If it’s almost time for your next dose, skip the missed one. Do not double up.

Overdose symptoms:

• Severe muscle weakness
• Nausea and vomiting
• Increased sweating
• Bradycardia (slow heart rate)

Contact a poison control center or seek emergency medical help immediately.

Contraindications

• Allergic to Pyridostigmine or any of its components
• History of asthma exacerbated by cholinergic medications

Brand Names / Alternatives

• Mestinon
• Regonol
• Generic name: Pyridostigmine