Pyridostigmine Bromide

Myasthenic Syndromes, Congenital, Constipation, Gas Poisoning + 6 more

Treatment

20 Active Studies for Pyridostigmine Bromide

What is Pyridostigmine Bromide

Pyridostigmine

The Generic name of this drug

Treatment Summary

Myasthenia gravis is an autoimmune disease that affects muscle tone and causes weakness and fatigue. The most common treatment for this condition is a type of medication called acetylcholinesterase inhibitors. The most commonly used medication is pyridostigmine, which is more effective than other types of acetylcholinesterase inhibitors and has fewer side effects. Pyridostigmine can also be used to treat certain types of nerve agent poisoning and congenital myasthenic syndromes. It is available in oral tablets, extended-release tablets, syrups, and injections.

Mestinon

is the brand name

image of different drug pills on a surface

Pyridostigmine Bromide Overview & Background

Brand Name

Generic Name

First FDA Approval

How many FDA approvals?

Mestinon

Pyridostigmine

1955

38

Effectiveness

How Pyridostigmine Bromide Affects Patients

Pyridostigmine bromide is a type of medication that blocks the enzyme in the body responsible for breaking down a certain type of chemical (acetylcholine). It is similar to another drug called neostigmine but tends to have fewer side effects and a longer lasting effect. Taking too much of this medication can lead to a cholinergic crisis, which causes symptoms similar to a muscle-weakening disease. If this happens, doctors will usually prescribe atropine to counter the effects, such as slow heart rate and too much mucus in the lungs.

How Pyridostigmine Bromide works in the body

Myasthenia gravis is a condition where the body’s own antibodies damage the muscles and make it difficult for them to contract. Pyridostigmine is a medicine commonly used to treat myasthenia gravis by blocking the action of an enzyme that breaks down acetylcholine, a neurotransmitter. This leads to increased levels of acetylcholine in the neuromuscular junction and helps to improve muscle strength and reduce fatigue. Pyridostigmine is also used to treat congenital myasthenic syndromes, which are caused by mutations in more than 30 different genes. However, in

When to interrupt dosage

The advised dosage of Pyridostigmine Bromide is contingent upon the diagnosed condition, including non-depolarizing neuromuscular blocking agents, Neuromuscular Blockade and Gas Poisoning. The extent of dosage is determined by the method of administration (e.g. Oral or Solution - Oral) featured in the table beneath.

Condition

Dosage

Administration

Gas Poisoning

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Gas Poisoning

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Hypotension, Orthostatic

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

non-depolarizing neuromuscular blocking agents

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Myasthenic Syndromes, Congenital

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Constipation

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Neuromuscular Blockade

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Myasthenia Gravis

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Postpoliomyelitis Syndrome

, 180.0 mg, 60.0 mg, 5.0 mg/mL, 60.0 mg/mL, 30.0 mg

, Oral, Tablet, extended release, Tablet, extended release - Oral, Tablet, Tablet - Oral, Intravenous; Parenteral, Injection, solution, Injection, solution - Intravenous; Parenteral, Intramuscular; Intravenous, Liquid - Intramuscular; Intravenous, Liquid, Syrup - Oral, Solution - Oral, Solution

Warnings

Pyridostigmine Bromide Contraindications

Condition

Risk Level

Notes

Mechanical Intestinal Obstruction

Do Not Combine

mechanical urinary obstructions

Do Not Combine

Severe Hypersensitivity Reactions

Do Not Combine

Pyridostigmine may interact with Pulse Frequency

There are 20 known major drug interactions with Pyridostigmine Bromide.

Common Pyridostigmine Bromide Drug Interactions

Drug Name

Risk Level

Description

Acetylcholine

Minor

The risk or severity of adverse effects can be increased when Pyridostigmine is combined with Acetylcholine.

Agmatine

Minor

The therapeutic efficacy of Agmatine can be decreased when used in combination with Pyridostigmine.

Alcuronium

Minor

The therapeutic efficacy of Alcuronium can be decreased when used in combination with Pyridostigmine.

Amantadine

Minor

The therapeutic efficacy of Amantadine can be decreased when used in combination with Pyridostigmine.

Amitriptyline

Minor

The therapeutic efficacy of Amitriptyline can be decreased when used in combination with Pyridostigmine.

Pyridostigmine Bromide Toxicity & Overdose Risk

Not much is known about the toxicity of pyridostigmine. But those who overdose may experience a slow heart rate, excess mucus in the lungs, and a severe reaction called cholinergic crisis. Treatment for an overdose includes providing supportive care.

image of a doctor in a lab doing drug, clinical research

Pyridostigmine Bromide Novel Uses: Which Conditions Have a Clinical Trial Featuring Pyridostigmine Bromide?

59 clinical trials are currently evaluating the potential of Pyridostigmine Bromide in managing Myasthenic Syndromes, Congenital Disorders, Chronic Constipation and Gas Poisoning.

Condition

Clinical Trials

Trial Phases

Myasthenia Gravis

19 Actively Recruiting

Phase 2, Phase 3, Not Applicable, Phase 1

Constipation

15 Actively Recruiting

Phase 2, Not Applicable, Phase 4, Phase 3, Phase 1

Hypotension, Orthostatic

0 Actively Recruiting

Neuromuscular Blockade

5 Actively Recruiting

Not Applicable, Phase 4

Myasthenic Syndromes, Congenital

2 Actively Recruiting

Phase 1

Gas Poisoning

0 Actively Recruiting

non-depolarizing neuromuscular blocking agents

0 Actively Recruiting

Gas Poisoning

0 Actively Recruiting

Postpoliomyelitis Syndrome

2 Actively Recruiting

Not Applicable

Pyridostigmine Bromide Reviews: What are patients saying about Pyridostigmine Bromide?

5

Patient Review

8/21/2014

Pyridostigmine Bromide for Myasthenia Gravis

Prior to taking this medication, I was experiencing double vision and fatigue. I also had difficulty walking and holding my urine. After about a month of taking the medication, the double vision has cleared but I'm still quite tired.

5

Patient Review

1/17/2015

Pyridostigmine Bromide for Myasthenia Gravis

This medication has been a godsend. I was diagnosed with MG in 2003 and since then, I've been taking this treatment every four hours. It's allowed me to maintain an active lifestyle, even though by the end of the week I'm usually pretty exhausted.

4.7

Patient Review

12/19/2014

Pyridostigmine Bromide for Myasthenia Gravis

This drug has been incredibly effective for me. I was suffering from debilitating double vision, but after starting this medication (30mg 3x/day), I feel like I've gotten my life back. My only remaining issue is very slight double vision if I look to the far right, but it's a small price to pay compared to where I was before.

4.3

Patient Review

10/1/2011

Pyridostigmine Bromide for Myasthenia Gravis

I didn't have a great experience with this medication. It made me feel crummy for weeks, and I only got relief when I stopped taking it. Let's hope the side effects don't come back...

4.3

Patient Review

3/12/2014

Pyridostigmine Bromide for Myasthenia Gravis

While this medication has been great for my MG, it unfortunately gives me stomach cramps and diarrhea. This is made worse by the fact that I also have to take Crestor for my cholesterol levels.

4

Patient Review

7/28/2019

Pyridostigmine Bromide for Myasthenia Gravis

I only found out about this treatment a year ago when I had serious respiratory problems. All the symptoms presented in the hospital, but at first we thought it was the antibiotics! It took some time to increase the dosage, but now I don't have any more double vision, shakiness, or difficulty swallowing. I'm getting stronger every day and am thankful that we caught it early.

4

Patient Review

5/13/2017

Pyridostigmine Bromide for Myasthenia Gravis

This isn't a cure-all for M Gravis, but it definitely helps in managing the condition.

4

Patient Review

7/22/2022

Pyridostigmine Bromide for Myasthenia Gravis

I was recently diagnosed with MG and started this medication 10 days ago. The first week went great, but for the last four days I've had really bad diarrhea, stomach cramps, and leg/foot cramps at night. My doctor advised me to change my dosage from 3 60 mg pills to 2 30 mg pills to see if that improves the problem. So far, my drooping eyelids have improved and I think my vision has become less blurry.

3.7

Patient Review

10/2/2017

Pyridostigmine Bromide for Myasthenia Gravis

This treatment stopped my double vision, but I quickly began to experience fatigue in my arms and legs. My eye lids also droop from time to time, which can be quite severe.

3.7

Patient Review

11/12/2019

Pyridostigmine Bromide for Myasthenia Gravis

This medication has helped my ocular myasthenia gravis in the past four months by clearing my vision and improving the drooping eyelid, however the side effects include fatigue, nausea, some problems swallowing and muscle weakness in the neck and shoulders.

3

Patient Review

4/21/2012

Pyridostigmine Bromide for Myasthenia Gravis

This medication helped my Myasthenia Gravis by the third day. However, I've experienced cramping and leg twitches at night which has made it difficult to sleep.

2.7

Patient Review

4/10/2013

Pyridostigmine Bromide for Myasthenia Gravis

This medication has helped me regain some muscle strength. The side effects have dissipated which is great. It's not a cure-all by any means, but it helps me get through the day.

2.3

Patient Review

8/3/2013

Pyridostigmine Bromide for Prevent Poisoning by a Toxic War Gas Inhaled or Absorbed by Skin

I was given this during the gulf war to fight nerve agent if attacked by it. Had severe headache, and never did a thing for me.

1.7

Patient Review

7/23/2017

Pyridostigmine Bromide for Myasthenia Gravis

The effects of this drug only last for four hours, even when taking the recommended 30mg. Cutting the tablet is also not very effective, especially if you have issues with dexterity.

1.3

Patient Review

12/25/2013

Pyridostigmine Bromide for Myasthenia Gravis

The directions on the bottle are confusing and difficult to follow. I work a lot of hours and can't get into a regular routine of taking the pills, which makes it hard to gauge whether or not the treatment is working.

1

Patient Review

4/27/2013

Pyridostigmine Bromide for Prevent Poisoning by a Toxic War Gas Inhaled or Absorbed by Skin

I have MG and sever double vision. I must type with only one eye open and drive the same way. I am taking 60 mg every 4 hours. Perhaps I will go to 30 mg every 2 hours. I may have to increase the dosage to 420 mg or more. I am only on the drug for about 2 weeks. The drug has caused urgent urination, and constant diarrhea or irritable bowel.
image of drug pills surrounding a glass of water symbolizing drug consumption

Patient Q&A Section about pyridostigmine bromide

These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

Is pyridostigmine a muscle relaxer?

"This medicine is called pyridostigmine. It is helpful for increasing muscle strength and is used to treat myasthenia gravis. It can also be used to reverse the effects of some muscle relaxers."

Answered by AI

What is the drug pyridostigmine bromide used for?

"PB is a drug that has been used for many years to protect people from the harmful effects of nerve agents. It is also used to treat myasthenia gravis and to reverse the effects of surgery."

Answered by AI

What type of drug is pyridostigmine bromide?

"The drug Mestinon belongs to a class of drugs called Acetylcholinesterase Inhibitors, which act on the peripheral nervous system."

Answered by AI

What is pyridostigmine side effects?

"The following effects may occur: nausea, vomiting, diarrhea, abdominal cramps, increased saliva/sweating, runny nose, decreased pupil size, or increased urination. If you experience any of these effects for an extended period of time, or if they worsen, consult your doctor or pharmacist."

Answered by AI

Clinical Trials for Pyridostigmine Bromide

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Image of Nationwide Children's Hospital in Columbus, United States.

TetraGraph for Neuromuscular Blockade

Any Age
All Sexes
Columbus, OH

In most clinical instances, direct laryngoscopy and endotracheal intubation is performed after a set time (generally 60 seconds) following the administration of a neuromuscular (NM) blocking agent, rocuronium. Although the average onset time is 60 seconds, clinical studies show a standard deviation around the mean onset time of 10-20 seconds, meaning that a significant number of patients do not achieve complete NM blockade by 60 seconds. Given the above noted variability, complete NM blockade may not be achieved in 60 seconds in a significant percentage of patients, resulting in more problematic direct laryngoscopy and endotracheal intubation. Various studies have shown a higher incidence of perioperative respiratory events and postoperative concerns (sore throat, vocal cord injury) when NM blockade is not complete prior to endotracheal intubation. This study aims to use the TetraGraph monitor to clearly identify onset times of rocuronium. Additionally, whenever feasible based on the clinical needs of the case, recovery times after the single dose of rocuronium will be recorded.

Waitlist Available
Has No Placebo

Nationwide Children's Hospital

Joseph Tobias, MD

Image of Profound Research LLC - Carlsbad in Carlsbad, United States.

Empasiprubart + Efgartigimod for Myasthenia Gravis

18+
All Sexes
Carlsbad, CA

This study is part of the ADAPT Forward platform study (NCT07294170). ADAPT Forward is a platform study with the aim to look at how safe different drugs are and how well they work for people with myasthenia gravis. The goal is to find the best therapeutic approach to reduce patients' side effects and improve their quality of life. The aim of this ISA1 is to evaluate the safety and therapeutic relevance of empasiprubart as add-on therapy to efgartigimod in participants with AChR-Ab seropositive generalized myasthenia gravis. The ADAPT Forward master protocol is registered on https://clinicaltrials.gov/study/NCT07294170 More information can be found here: https://clinicaltrials.argenx.com/adaptforward1

Phase 2
Recruiting

Profound Research LLC - Carlsbad (+12 Sites)

argenx

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Image of Banner - University Medical Center South in Tucson, United States.

Dexmedetomidine + Dexamethasone for Postoperative Pain

18 - 75
All Sexes
Tucson, AZ

The goal of this clinical study is to improve upon the standard practice of utilizing nerve blocks to enhance the satisfaction of patients undergoing shoulder, or foot and ankle surgery regarding their quality of pain control, the duration of their nerve blocks, as well as the avoidance of opioid medications and subsequently their undesirable side effects. The researchers hypothesize that dexmedetomidine and dexamethasone (Dex-Dex) will work synergistically as adjuncts in a low, non-weight based formula. This would allow the investigators to improve patient satisfaction by providing them with a superior means of pain control that is longer in duration with a decreased probability of unwanted side effects. The proposed clinical study will be a prospective, randomized control trial.

Phase 1 & 2
Waitlist Available

Banner - University Medical Center South

Ronald Tang, MD

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