Pyridostigmine
About Pyridostigmine
Pyridostigmine is used to treat myasthenia gravis (muscle weakness). Besides this, Pyridostigmine also treats paralytic ileus (a rare form of constipation), postoperative urinary retention, and prophylaxis to military exposure to any nerve poisoning gas. Myasthenia gravis is a long-term neuromuscular disease that leads to musculoskeletal weakness caused by excess activity of a protein (cholinesterase protein).
Pyridostigmine contains ‘Pyridostigmine’, which works by stopping the excessive cholinesterase activity (an enzyme required for the breakdown of a neurotransmitter called acetylcholine) involved in communication between nerve impulses and muscle movements. Thereby, Pyridostigmine helps in proper muscle functioning and prevents muscle weakness.
Take Pyridostigmine 30-60 minutes before food. Swallow Pyridostigmine as a whole; do not crush or chew the tablet. You are advised to take Pyridostigmine as long as your doctor has prescribed it for you, depending on your medical condition. In some cases, you may experience certain common side effects, such as stomach pain, nausea, vomiting, diarrhoea, sweating, cough with mucus, rash, muscle cramps, and blurred vision. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.
Inform your doctor before taking Pyridostigmine if you have asthma, high blood pressure, glaucoma, breathing problems, coronary obstruction, stomach ulcer, epilepsy, Parkinson’s disease, or kidney problems. Consult your doctor before taking Pyridostigmine if you are pregnant before taking Pyridostigmine if you are pregnant or breastfeeding. Pyridostigmine may cause dizziness and vision problems, so drive or operate machinery only if you are alert. Avoid consuming alcohol while taking Pyridostigmine as it may cause increased dizziness. Pyridostigmine can be given to children if prescribed by the doctor; the dose depends upon the child’s age. Keep your doctor informed about your health condition and medicines you are taking to rule out unpleasant side effects.
Uses of Pyridostigmine
Medicinal Benefits
Pyridostigmine belongs to the group of medicines called cholinesterase inhibitors used to treat myasthenia gravis (muscle weakness). Pyridostigmine works by stopping the excessive activity of cholinesterase, thus helping the muscles to work properly. Additionally, Pyridostigmine is also used to treat paralytic ileus (a rare form of constipation), postoperative urinary retention, and prophylaxis to soman nerve agent poisoning. Pyridostigmine affects the chemicals in the body which are involved in communication between nerve impulses and muscle movements. Thereby, Pyridostigmine helps in treating myasthenia gravis.
Directions for Use
Storage
Side Effects of Pyridostigmine
- Stomach pain
- Nausea
- Vomiting
- Diarrhoea
- Increased salivation (drooling)
- Sweating, cough with mucus
- Rash
- Muscle cramps
- Blurred vision
Drug Warnings
Do not take Pyridostigmine if you are allergic to any of its contents; if you are constipated or cannot urinate unless prescribed by the doctor. Inform your doctor before taking Pyridostigmine if you have asthma, high blood pressure, glaucoma, breathing problems, coronary obstruction, stomach ulcer, epilepsy, Parkinson’s disease, kidney problems, vagotonia (overactive vagus nerves), overactive thyroid; if you have had surgery to remove thymus gland or if you due to have any surgery. Consult your doctor before taking Pyridostigmine if you are pregnant before taking Pyridostigmine if you are pregnant or breastfeeding. Pyridostigmine may cause dizziness and vision problems; so, drive or operate machinery only if you are alert. Avoid consuming alcohol while taking Pyridostigmine as it may cause increased dizziness.
Drug Interactions
Drug-Drug Interactions: Pyridostigmine may have interaction with anticholinergic (atropine, glycopyrrolate), corticosteroids (prednisone), and skeletal muscle relaxant (succinylcholine).
Drug-Food Interactions: No interactions found/established.
Drug-Disease Interactions: Pyridostigmine may have interactions with asthma, high blood pressure, glaucoma, bradycardia (slow heart rate), bronchospasm, Parkinsonism, seizures, hyperthyroidism, peptic ulcer disease, and coronary artery disease.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid consuming alcohol while taking Pyridostigmine as it may cause increased dizziness.
Pregnancy
cautionPyridostigmine belongs to the pregnancy category C. Please consult your doctor before taking Pyridostigmine if you are pregnant or planning for pregnancy.
Breast Feeding
cautionSmall amounts of Pyridostigmine may pass into breastmilk. Please consult your doctor before taking Pyridostigmine if you are breastfeeding.
Driving
unsafePyridostigmine may cause dizziness and vision problems. So, drive only if you are alert.
Liver
cautionDose adjustment may be needed. Please consult your doctor before taking Pyridostigmine if you have liver impairment/liver disease before taking Pyridostigmine.
Kidney
cautionDose adjustment may be needed. Please consult your doctor if you have any concerns regarding this or if you have kidney impairment/kidney disease before taking Pyridostigmine.
Children
unsafeNot recommended for use in anyone less than 18 years of age
Habit Forming
Diet & Lifestyle Advise
- Maintain a healthy weight. Include vegetables, fruits and grains in your diet.
- Diet low in fat, saturated fat and cholesterol would be helpful.
- Use salt and sugars in moderation.
- Avoid consumption of alcohol.
- Avoid processed and fried foods.
- Try eating soft, mashed, or pureed foods as they are easy to swallow.
- Avoid dry, chunky and chewy foods.
- Regularly sip water during meals and snacks as it helps to moisten and soften the food.
- Add thickening agents to liquid foods as liquid foods may get into the lungs and cause choking.
- Be careful while swallowing foods and liquids.
Special Advise
Pyridostigmine might stop or increase the effects of skeletal muscle relaxants used in the surgery. Inform the doctor that you are taking Pyridostigmine.
You should not use Pyridostigmine if you have a bladder or bowel obstruction.
Pyridostigmine is not approved for use by anyone younger than 18 years old.
Prolonged use of Pyridostigmine may cause gastrointestinal side effects due to increased gut peristalsis causing abdominal cramping, frequent bowel movements, or diarrhoea. However, these side effects can be managed with OTC items antidiarrheal preparations.
Patients Concern
Disease/Condition Glossary
Myasthenia gravis: It is an autoimmune neuromuscular disease which causes skeletal muscle weakness. The immune system mistakenly attacks its own healthy tissue, leading to damage of the neuromuscular membrane. This reduces the effect of acetylcholine, a neurotransmitter which is crucial for the communication between nerve cells and muscles. Myasthenia gravis occurs when the communication between nerve cells and muscles becomes impaired. This prevents crucial muscle contractions, thereby leading to muscle weakness. The most affected muscles are those of the face and eyes. Symptoms of myasthenia gravis include double vision, drooping eyelids, difficulty chewing or swallowing, weakness, problems with lifting objects, and trouble talking and walking.
Paralytic ileus: It is a condition in which there is obstruction of the intestine due to paralysis of intestinal muscles. This prevents the passage of food and leads to their accumulation in the intestine. Paralytic ileus occurs due to malfunctioning of nerves and muscles in the intestine, thereby impairing digestive movement.
FAQs
Pyridostigmine is used to treat myasthenia gravis (muscle weakness). Besides this, it also treats paralytic ileus (a rare form of constipation), postoperative urinary retention, and prophylaxis to military exposure to any nerve-poisoning gas.
Pyridostigmine works by stopping the excessive cholinesterase activity (an enzyme necessary for the breakdown of a neurotransmitter called acetylcholine) involved in communication between nerve impulses and muscle movements. Thereby, Pyridostigmine helps in proper muscle functioning and prevents muscle weakness.
Pyridostigmine is used as prophylaxis against the lethal effects of soman nerve agent poisoning especially by military. It is intended to be used in conjunction with atropine and pralidoxime therapy and protective garments and gas-mask.
Do not stop taking Pyridostigmine on your own. To treat your condition effectually continue taking Pyridostigmine for as long as your doctor has prescribed it. Do not be reluctant to speak with your doctor if you experience any difficulty while taking Pyridostigmine.
Caution is needed in patients with asthma, breathing difficulty, wheezing and chronic cough as Pyridostigmine may worsen the condition. Please consult your doctor before taking Pyridostigmine if you have asthma or any breathing problems.
Talk to your doctor before taking Pyridostigmine if you have hypertension (high blood pressure) as it may cause insignificant changes such as elevated blood pressure.
Anticholinergic drugs are often used in the treatment of glaucoma. Pyridostigmine is a cholinergic inhibitor, and its use in patients with glaucoma may cause additive effects which could lead to night vision problems. Please consult your doctor before taking Pyridostigmine if you have glaucoma.
Pyridostigmine may cause side effects such as nausea, vomiting, diarrhoea, stomach pain, muscle cramps, blurred vision, rash and increased salivation. If these side effects persist or worsen, please consult your doctor.
Pyridostigmine does not cause high blood pressure. In fact, intake of high dose of Pyridostigmine can cause low blood pressure.
No, Pyridostigmine should not be crushed or chewed. It should be taken as a whole with water.
Pyridostigmine does not cause increase in heartbeats. On the other hand, it can be used in the treatment of increase in heartbeats in postural orthostatic tachycardia syndrome (POTS) where there is an abnormal increase in the heartbeats while standing from a lying position.
Pyridostigmine should not be cut in half unless your doctor tells you to take a half tablet and it has a score mark on it. It should not be chewed or crushed before taking.
Pyridostigmine does not cure myasthenia gravis but relieves the symptoms of it by reducing and improving muscle weakness. The duration for which you must take Pyridostigmine will depend on your needs. Do not stop taking Pyridostigmine until and unless advised by your doctor, even if you start feeling better.
A very small amount of Pyridostigmine may pass into breast milk, which may or may not affect your baby. Please take your doctor’s advice before taking Pyridostigmine if you are breastfeeding.
No, do not take Pyridostigmine for constipation. It is used only when constipation occurs due to intestinal paralysis and strictly on prescription by the doctor.
Pyridostigmine should not be taken by patients who are allergic to it, who have constipation or difficulty urinating, unless the doctor has advised to use this medicine.
If you have accidentally taken more than the required dose, seek medical help immediately. An overdose of Pyridostigmine may cause nausea, vomiting, stomach pain, diarrhea, salivation, excessive sweating, blurred vision, difficulty in breathing, excessive weakness, and even paralysis.
No, Pyridostigmine is not a steroid. It belongs to the group of medicines called anticholinesterases.
No, there is no proof that Pyridostigmine has abuse potential.
No, Pyridostigmine does not cause weight gain. However, if you gain weight, it may be due to inactivity related to muscle weakness in myasthenia gravis.
Yes, Pyridostigmine is safe if used as advised by the doctor. Do not exceed the recommended dose.
Pyridostigmine may cause blurred vision. Thus, you should avoid driving until you know how Pyridostigmine affects you.
