Mestinon (Pyridostigmine Bromide)

Mestinon can cause cholinergic crisis, characterized by excessive salivation, sweating, muscle cramps, and weakness, which may be life-threatening. Patients should be closely monitored for signs of overmedication, and dosage adjustments should be made accordingly.

Do not take this medication if you have an allergy to Pyridostigmine or any ingredients in this Mestinon.

Speak to your doctor about any of your past or existing medical conditions, especially if you have: asthma or COPD, intestinal/stomach blockage, kidney or lung disease, urinary blockage, slow/irregular heartbeat or diabetes.

Notify your doctor of any other medications, supplements, herbal medicines, or vitamins you are currently taking. This includes weight loss medications, such as Ozempic.

Consult your doctor if you are pregnant or breastfeeding.

Do not use this medication if you have bladder or bowel obstruction.

Since this medication can cause blurred vision, do not drive or operate any heavy machinery after taking it. Please do not drink alcohol after taking Mestinon as it can increase specific side effects of Pyridostigmine.

This medication is not approved to be taken by anyone under the age of 18.

The dosage, route, and frequency of administration depend on the requirements and clinical response of the patients. The dosage schedule should be adjusted for each patient and changed as the need arises. Dosage requirements in patients with myasthenia gravis may vary from day to day, according to the patient’s remissions and exacerbations of the disease and the physical and emotional stress. More significant portions of the label daily dose may be given when the patient is more prone to fatigue (afternoon, mealtimes, etc.).

Although the failure of patients to show clinical improvement may reflect under dosage, it can also be indicative of overdosage. As is true of all cholinergic drugs, overdosage of Mestinon (pyridostigmine) may result in cholinergic crisis, a state characterized by increasing muscle weakness which, through the involvement of the muscles of respiration, may lead to death. Myasthenic crisis due to an increase in the severity of the disease is also accompanied by extreme muscle weakness and thus may be difficult to distinguish from the cholinergic crisis on a symptomatic basis. Such differentiation is significant since increases in doses of Mestinon (pyridostigmine) or other drugs of this class in the presence of cholinergic crisis or a refractory or “insensitive” state could have grave consequences.

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