Pyridostigmine bromide

By Medically reviewed by hellodoktor

Generic Name: Pyridostigmine bromide Brand Name(s): Pyridostigmine bromide.

Uses

What is pyridostigmine bromide used for?

Pyridostigmine bromide is a cholinesterase inhibitor. It works by improving nerve impulses in muscles so that the muscles are better able to work.

Pyridostigmine bromide is commonly used for treating myasthenia gravis. It may also be used for other conditions as determined by your doctor.

How should I take pyridostigmine bromide?

Pyridostigmine bromide is usually administered as an injection at your doctor’s office, hospital, or clinic. If you are using pyridostigmine bromide at home, carefully follow the injection procedures taught to you by your health care provider.

If pyridostigmine bromide contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.

Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.

How do I store pyridostigmine bromide?

Pyridostigmine bromide is usually handled and stored by a health care provider. If you are using pyridostigmine bromide at home, store pyridostigmine bromide as directed by your pharmacist or health care provider. Keep pyridostigmine bromide out of the reach of children and away from pets.

Precautions & warnings

What should I know before using pyridostigmine bromide?

Before using pyridostigmine bromide, tell your doctor if:

  • You are allergic to any ingredient in pyridostigmine.
  • You are taking quinine or quinidine.
  • You are pregnant, planning to become pregnant, or are breastfeeding.
  • You are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
  • You have allergies to medicines, foods, or other substances.

Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using pyridostigmine.

Use pyridostigmine bromide with extreme caution in children. Safety and effectiveness have not been confirmed.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using pyridostigmine bromide during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking pyridostigmine bromide. Pyridostigmine bromide is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from pyridostigmine bromide?

Seek medical attention right away if any of these severe side effects occur:

  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Tightness in the chest
  • Swelling of the mouth, face, lips, or tongue
  • Diarrhea
  • Fainting
  • Increased production of saliva
  • Increased sweating
  • Muscle weakness
  • Nausea
  • Small pupils
  • Stomach cramps
  • Trouble breathing
  • Vision changes
  • Vomiting
  • Weakness

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with pyridostigmine bromide?

Pyridostigmine bromide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products may interact with this drug, such as:

  • Quinine or quinidine because effectiveness of pyridostigmine bromide may be decreased.
  • Succinylcholine because actions and side effects may be increased by pyridostigmine.

Does food or alcohol interact with pyridostigmine bromide?

Pyridostigmine bromide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with pyridostigmine bromide?

Pyridostigmine bromide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Tell your doctor if you have:

  • Heart problems (e.g., heart block, slow heartbeat)
  • A urinary tract infection
  • Asthma
  • Kidney problems
  • A stomach, intestinal, or urinary blockage

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using pyridostigmine bromide.

What is the dose of pyridostigmine bromide for an adult?

Myasthenia Gravis

Tablets/syrup: The recommended dose is 600 mg/day spaced to provide maximum relief.

Sustained release: The recommended dose is 180-540 mg PO qDay or q12hr; not to exceed 1.5 g/day.

Reversal of Nondepolarizing Muscle Relaxants

The recommended dose is 0.1-0.25 mg/kg/dose.

The recommended dose is 10-20 mg generally effective; full recovery may occur as early as <15 min but may require >30 min.

To minimize side effects 0.6-1.2 mg IV atropine sulfate recommended immediately prior to pyridostigmine.

What is the dose of pyridostigmine bromide for a child?

Myasthenia Gravis

Children

  • The recommended dose is 7 mg/kg/day PO divided q4hr.
  • The recommended dose is 0.05-0.15 mg/kg IV/IM q4-6hr; not to exceed 10 mg/dose.

Neonates

  • The recommended dose is 5 mg PO q4-6hr.
  • The recommended dose is 0.05-0.15 mg/kg IV/IM q4-6hr; not to exceed 10 mg/dose.

Reversal of Nondepolarizing Muscle Relaxants

The recommended dose is 0.1-0.25 mg/kg/dose IV.

Dosing range: 0.1-0.25 mg/kg/dose; full recovery may occur as early as <15 min but may require >30 min.

How is pyridostigmine bromide available?

Pyridostigmine bromide is available in the following dosage forms and strengths:

  • Pyridostigmine bromide injection solution 5mg/mL
  • Pyridostigmine bromide tablet, controlled release 180mg
  • Pyridostigmine bromide tablet 60mg
  • Pyridostigmine bromide syrup 60mg/5mL (240mL)

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room

What should I do if I miss a dose?

If you miss a dose of pyridostigmine bromide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 19, 2017 | Last Modified: September 13, 2019

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