Product Description

Common use
Mestinon (Pyridostigmine) affects chemicals in the body that are involved in the communication between nerve impulses and muscle movement.
Pyridostigmine is used to treat the symptoms of myasthenia gravis. It is also used in military personnel who have been exposed to nerve gas.
Pyridostigmine may also be used for purposes not listed in this medication guide.

Dosage and direction

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Take this medicine with food or milk if it upsets your stomach. Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.
Measure liquid medicine with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one.
The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it.
Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.
If you need surgery, tell the surgeon ahead of time that you are using pyridostigmine. You may need to stop using the medicine for a short time. Store at room temperature away from moisture and heat.
Take the medicine as prescribed by your doctor.

Storage

Keep the tablets in their original container, along with the canister of moisture-absorbing preservative that comes with this medicine.

Safety information

You should not use pyridostigmine if you are allergic to it, or if you have a bladder or bowel obstruction.
To make sure you can safely take pyridostigmine, tell your doctor if you have any of these other conditions:
asthma;
kidney disease;
an ulcer or other serious stomach disorder;
high blood pressure, heart disease;
overactive thyroid; or
a history of seizures.
It is not known whether pyridostigmine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether pyridostigmine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Drugs interaction
Tell your doctor about all other medicines you use, especially:
atropine (Atreza, Sal-Tropine);
belladonna (Donnatal, and others);
benztropine (Cogentin);
clidinium (Quarzan);
clozapine (Clozaril, FazaClo);
dimenhydrinate (Dramamine);
methscopolamine (Pamine), scopolamine (Transderm Scop);
glycopyrrolate (Robinul);
mepenzolate (Cantil);
bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
cold medicine, allergy medicine, or sleeping pills that contain an antihistamine such as diphenhydramine (Tylenol PM) or doxylamine (Unisom);
heart rhythm medication such as quinidine (Quin-G), procainamide (Procan, Pronestyl), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others;
irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine);
medicine to treat Alzheimer's dementia, such as donepezil (Aricept), rivastigmine (Exelon), or tacrine (Cognex); or
a steroid such as betamethasone (Celestone) or dexamethasone (Cortastat, Dexasone, Solurex, DexPak).
This list is not complete and other drugs may interact with pyridostigmine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Possible side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using pyridostigmine and call your doctor at once if you have any of these serious side effects:
extreme muscle weakness, muscle twicthing;
slurred speech, vision problems;
severe vomiting or diarrhea;
cough with mucus;
confusion, anxiety, panic attacks;
seizure (convulsions); or
worsening or no improvement in your symptoms of myasthenia gravis.
Less serious side effects may include:
cold sweat, pale skin;
urinating more than usual;
watery eyes;
mild nausea, vomiting, or upset stomach;
warmth or tingly feeling; or
mild rash or itching.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.