Pyridostigmine bromide is used to treat myasthenia gravis (muscle weakness disorder).
This medicine may also be used to treat paralytic ileus (bowel obstruction caused by slow movement or paralysis of the intestines) and urinary retention (inability to completely empty the bladder when urinating) after an operation.
Take Pyridostigmine bromide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
If you are taking this medicine for myasthenia gravis, you should try to take it at times when your muscles are needed the most, such as when getting up or before a meal. Try to take it at the same time each day.
This medicine is available as a conventional tablet, extended-release tablet, and oral solution.
If you are taking the conventional tablet, swallow the tablet whole with a glass of water.
If you are taking the extended-release type of tablet, swallow it whole. Do not divide, chew, or crush the tablet.
If you are taking the oral solution, use the measuring device (e.g. dropper, spoon) provided to measure your dose. The oral solution may also be administered via nasogastric feeding or enteral tube feeding. Always flush the tubing with 5 mL of water after each dose of this medicine to ensure that the full dose is taken.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition or your response to the medication.
Pyridostigmine bromide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- intestinal obstruction (blocked bowel)
- urinary obstruction (blocked urinary tract [including the kidneys, ureters, bladder or urethra] which prevents normal flow of urine out of the body)
as Pyridostigmine bromide may not be suitable for you.
Inform your doctor if you have the following conditions:
- lung problem or disease e.g. asthma, chronic obstructive pulmonary disease (a long-term lung disease that causes airflow obstruction making it hard to breathe)
- heart disease e.g. heart rhythm disorder
- low blood pressure
- vagotonia (overactivity of nerve causing slowed heartbeat, decreased heart output, and fainting)
- epilepsy (fits or seizures)
- Parkinson's disease (disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement and impaired balance or walking)
- hyperthyroidism (overactive thyroid gland)
- peptic ulcer (open sores in the lining of the stomach, small intestine, or lower food pipe)
- glaucoma (increased pressure in the eye)
- recent operation to remove thymus gland (a small organ located in the upper chest behind the breastbone)
- kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Pyridostigmine bromide to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. ECG [test used to record the electrical activity of the heart]) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring of heart rate and certain symptoms such as nausea, vomiting, diarrhoea, and increased salivation may also be needed.
Pyridostigmine bromide may impair your vision and affect your ability to react. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: nausea, stomach cramps, discomfort or pain, vomiting, diarrhoea, excessive production of saliva or phlegm, excessive sweating, sudden, compelling urge to pass urine, rash, and muscle cramps, twitching or weakness.
If you develop rashes, breathlessness, swollen mouth or eyes, stop taking this medicine and inform your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- anti-inflammatory medicines
- medicines used in organ transplants or certain immune disorders
- medicines used for blocking pain and sensation, and relaxing the muscles during procedures e.g. pancuronium, vecuronium, suxamethonium
- medicines used for irritable bowel syndrome (a long-term disorder of the digestive system) e.g. atropine, hyoscine
This list does not include all medicines that may interact with Pyridostigmine bromide.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
The oral solution should be used within 28 days after opening.
Protect from light and moisture.
Medicines must not be used past the expiry date.
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