Mestinon

Generic name: Pyridostigmine
Drug class: Cholinergic muscle stimulants

Usage of Mestinon

Mestinon (pyridostigmine) is used for conditions such as myasthenia gravis and congenital myasthenic syndrome, to increase muscle strength. Mestinon works by preventing the breakdown of acetylcholine, which is a natural substance that the body needs for muscles to work well. Mestinon may also be used to reverse the effect of non-depolarizing neuromuscular blocking medication and can be used in military personnel who have been exposed to nerve gas.

Mestinon is a cholinesterase inhibitor that works by reducing the breakdown of acetylcholine in the neuromuscular junction, this increases the signals between nerves and muscles and relieves symptoms of muscle weakness.

Clinical trials have used pyridostigmine to treat postural orthostatic tachycardia syndrome (POTS) but is not FDA approved for this condition.

Mestinon is available as Mestinon 60mg tablets, Mestinon Timespan 180mg (sustained release tablet) and Mestinon Oral Solution 60mg/5ml.

Mestinon 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 Mestinon and call your doctor at once if you have any of these serious side effects:

extreme muscle weakness;

loss of movement in any part of your body;

weak or shallow breathing;

slurred speech, vision problems; or

worsening or no improvement in your symptoms of myasthenia gravis.

Common side effects of Mestinon may include:

stomach pain, nausea, vomiting, diarrhea;

muscle cramps, twitching;

sweating, increased salivation;

cough with mucus;

rash; or

blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Mestinon

You should not use Mestinon if:

you are allergic to it, or any of the inactive ingredients.

if you have a bladder or bowel obstruction

Safety and effectiveness in pediatric patients have not been established.

To make sure you can safely take Mestinon, tell your doctor if you have any of these other conditions:

asthma; or

kidney disease.

Pregnancy

It is not known whether Mestinon will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Mestinon. The use of this medicine in women who may become pregnant requires weighing the drug’s potential benefits against its possible hazards to mother and child.

Breastfeeding

It is not known whether pyridostigmine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Relate drugs

How to use Mestinon

Mestinon is available as Mestinon 60mg tablets, Mestinon Timespan 180mg (sustained release tablet) and Mestinon Oral Solution 60mg/5ml.

Usual Adult Dose of Mestinon for Myasthenia Gravis:

Immediate-release tablets and syrup:

60 to 1500 mg daily (usually 600 mg/day divided into 5 or 6 doses) spaced to provide maximum relief.

Mestinon Timespan (Sustained-release tablet):

180 mg to 540 mg once or twice daily (separated by at least 6 hours); it may be necessary to use the immediate-release tablets or oral solution in conjunction with the sustained-release tablets for optimum control.

Comments:

Not all products are approved for the same indications. Refer to the manufacturer product information for indications.

Usual Adult Dose of Mestinon for Reversal of Nondepolarizing Muscle Relaxants:

As a reversal agent or antagonist to the neuromuscular blocking effects of nondepolarizing muscle relaxants.

The IV dose should be individualized.

The dosage information presented here is derived from studies based upon units of drug per unit of body weight and is intended to serve as a guide only:

When this drug is given IV to reverse the action of muscle relaxant drugs, it is recommended that atropine sulfate (0.6 to 1.2 mg) or an equipotent dose of glycopyrrolate be given immediately prior to or simultaneously with the administration of this drug to minimize excessive secretions and bradycardia.

Reversal doses range from 0.1 to 0.25 mg/kg.

The onset time to peak effect is dose-dependent; return of twitch height to 90% of control occurs within approximately 6 minutes following administration of a 0.25 mg/kg dose; at lower doses, full recovery usually occurs within 15 minutes in most patients, although others may require a half-hour or more.

Comments:

Not all products are approved for the same indications. Refer to the manufacturer product information for indications.

Satisfactory reversal can be evident by adequate voluntary respiration, respiratory measurements and use of a peripheral nerve stimulator device.

It is recommended that the patient be well ventilated and a patent airway maintained until complete recovery of normal respiration.

Dose Adjustments:

Renal dose adjustments: Lower doses may be required; however, no specific guidelines have been suggested. Caution recommended.

Liver Dose Adjustments: Data not available

Warnings

You should not use Mestinon if you have a bladder or bowel obstruction.

What other drugs will affect Mestinon

Other drugs may interact with pyridostigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

It is important to tell your doctor and pharmacist if you are taking:

allergy or cold medications

Dexamethasone (Decadron)

hydrocortisone (Hydrocortone)

magnesium-containing products

medications for heart arrhythmias

sleeping pills

vitamins.

This is not a full list of interactions. Click the link below to check for interactions.

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