Indicated for: myasthenia gravis
Route of administration: oral
Substance: pyridostigmine bromide (cholinesterase inhibitor)
ATC: N07AA02 (Nervous system | Parasympathomimetics | Anticholinesterases)
Pyridostigmine bromide is most commonly used for myasthenia gravis, a condition in which muscles tire quickly and become weak. It inhibits cholinesterase and increases acetylcholine at the junction between nerves and muscles. This can improve muscle strength, swallowing, speech, breathing and tolerance of daily activities.
It is taken by mouth, usually several times a day, because the effect lasts only a few hours. The dose is individualised according to symptoms, time of day, meals and activity needs. Do not change the dose on your own: too little may leave weakness uncontrolled, while too much may cause cramps, excessive secretions and worsening symptoms.
Common side effects include nausea, vomiting, diarrhoea, abdominal cramps, increased saliva, sweating, blurred vision, frequent urination, muscle cramps or twitching. Some people may develop slow heartbeat, low blood pressure, bronchial secretions, breathing difficulty or increased weakness. These symptoms may require dose adjustment.
Seek urgent medical help if breathing difficulty, severely impaired swallowing, fainting, very slow pulse, confusion or sudden worsening weakness occurs. Tell your doctor if you have asthma, lung disease, heart rhythm disorders, stomach ulcer, intestinal blockage or urinary obstruction. Pyridostigmine bromide controls symptoms, but does not cure the disease and should be part of neurological care.