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Mestinon (Generic Pyridostigmine)

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Why is this medication prescribed?

Mestinon is a brand name for the medication pyridostigmine bromide. It is commonly prescribed to treat certain neuromuscular conditions, particularly myasthenia gravis. Myasthenia gravis is an autoimmune disorder that affects the neuromuscular junction, leading to muscle weakness and fatigue. Mestinon helps improve muscle strength and function in individuals with myasthenia gravis.

How should this medicine be used?

Here’s how Mestinon is typically used:

  • Dosage: The dosage of Mestinon varies depending on the individual’s age, weight, and the severity of their condition. It is essential to follow the prescribing doctor’s instructions and the information provided on the medication label.
  • Timing: Mestinon is usually taken multiple times a day to maintain a consistent level of the drug in the body. The specific dosing schedule should be determined by a healthcare professional.
  • Taking with or without food: Mestinon can be taken with or without food. However, it’s important to maintain a consistent routine regarding food and medication to ensure that the drug works effectively.
  • Swallowing: Mestinon tablets should be swallowed whole with a full glass of water. Do not crush or chew the tablets unless directed to do so by your healthcare provider.
  • Extended-release formulation: There is also an extended-release (ER) version of Mestinon available. This version is designed to release the medication slowly over time, allowing for less frequent dosing. Follow your doctor’s instructions for the specific dosing regimen if you are prescribed the ER formulation.
  • Monitoring: Your healthcare provider will likely monitor your progress while taking Mestinon to ensure it is effective and to make any necessary adjustments to your dosage.
  • Do not stop abruptly: It is important not to stop taking Mestinon suddenly without consulting your healthcare provider, as this can lead to a worsening of symptoms.
  • Side effects: Like all medications, Mestinon may have side effects, including nausea, vomiting, diarrhea, excessive salivation, and muscle twitching. If you experience severe side effects or any unusual symptoms, contact your healthcare provider.
  • Interactions: Inform your healthcare provider of all other medications, supplements, or herbal remedies you are taking, as Mestinon may interact with certain drugs.
  • Special precautions: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of Mestinon with your healthcare provider, as special considerations may apply.

Always follow your healthcare provider’s guidance regarding the use of Mestinon, and do not make any changes to your medication regimen without consulting them first. This information is provided as a general overview and should not replace professional medical advice.

Other uses for this medicine

While Mestinon is primarily indicated for myasthenia gravis, it may be used off-label for other conditions as determined by a healthcare provider. Some of these off-label uses include:

  • Postural Orthostatic Tachycardia Syndrome (POTS): Mestinon may be prescribed to manage symptoms like low blood pressure and heart rate associated with POTS.
  • Lambert-Eaton Myasthenic Syndrome (LEMS): In some cases, Mestinon may be used to improve muscle function in individuals with LEMS.
  • Other disorders: Certain types of nerve-related conditions or muscle weakness disorders.

What special precautions should I follow?

Regarding special precautions when using Mestinon, here are some key points to consider:

  • Allergies: Inform your healthcare provider of any known allergies to medications or components of Mestinon.
  • Medical history: Provide your complete medical history, including any other medical conditions you have or have had, as well as a list of all medications and supplements you are currently taking.
  • Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of Mestinon with your healthcare provider. The potential risks and benefits will need to be carefully considered.
  • Kidney or liver disease: Mestinon is metabolized in the body and excreted primarily through the kidneys. If you have impaired kidney or liver function, your doctor may need to adjust the dosage accordingly.
  • Drug interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as Mestinon may interact with certain drugs, including other medications that affect neuromuscular function.
  • Side effects: Be aware of potential side effects of Mestinon, which can include nausea, vomiting, diarrhea, excessive salivation, and muscle twitching. Report any severe or unusual side effects to your healthcare provider.

Always follow your healthcare provider’s recommendations and guidance when using Mestinon or any other medication, and do not make any changes to your treatment regimen without consulting them first.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Mestinon. However, you should consider the following:

  • Consistent Diet: Try to maintain a consistent diet, as changes in diet could affect the absorption and effectiveness of the medication. Discuss any significant dietary changes with your doctor.
  • Timing of Meals: You may find it helpful to take Mestinon with food, as this can reduce the risk of gastrointestinal side effects.

What should I do if I forget a dose?

If you forget to take a dose of Mestinon, here are some general steps to follow:

  • Take the missed dose as soon as you remember, unless it is close to the time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule.
  • Do not take a double dose to make up for the missed one, as this can increase the risk of side effects.
  • If you have any concerns or questions about missed doses, contact your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Mestinon (pyridostigmine) can cause various side effects, some of which are common, while others are less common but more serious. It’s important to be aware of these potential side effects and to report any unusual or severe symptoms to your healthcare provider.

Common side effects of Mestinon may include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal cramps or pain
  • Increased salivation
  • Sweating
  • Increased urinary frequency
  • Muscle twitching or cramps
  • Dizziness
  • Weakness
  • Headache
  • Fatigue

These common side effects often occur due to the medication’s cholinergic effects on the body. Cholinergic effects result from the increased activity of acetylcholine, a neurotransmitter that Mestinon helps to maintain at neuromuscular junctions.

Less common but potentially more serious side effects of Mestinon may include:

  • Difficulty breathing or shortness of breath
  • Chest pain
  • Irregular or rapid heartbeat (tachycardia)
  • High blood pressure
  • Increased muscle weakness
  • Changes in vision, such as blurred vision or double vision
  • Allergic reactions, including rash, itching, swelling, severe dizziness, or difficulty breathing (seek immediate medical attention if any of these symptoms occur)

If you experience any of these less common but more severe side effects, seek immediate medical attention.

It’s important to note that individual responses to Mestinon can vary, and not everyone will experience these side effects. Your healthcare provider will typically monitor your progress while on Mestinon and may adjust your dosage as needed to balance symptom relief with side effects.

Inform your healthcare provider about all other medications, supplements, or herbal remedies you are taking, as Mestinon may interact with certain drugs. If you have concerns about the side effects of Mestinon or its interactions with other medications, discuss them with your healthcare provider. They can provide guidance and make any necessary adjustments to your treatment plan to ensure your safety and well-being.

What should I know about storage and disposal of this medication?


  • Room Temperature: Store Mestinon at room temperature, away from excessive heat, moisture, and direct sunlight.
  • Keep Container Tightly Closed: Keep the medication in its original container with the cap tightly closed to protect it from humidity and moisture.
  • Keep Out of Reach of Children: Ensure that Mestinon is stored in a place where children and pets cannot access it.


  • Dispose Properly: When it’s time to dispose of expired or unused Mestinon, follow your local regulations for medication disposal. Do not flush it down the toilet or throw it in the trash unless instructed to do so.
  • Take-Back Programs: Some communities have medication take-back programs or events where you can safely dispose of unused medications. Check with your local pharmacy or law enforcement agencies for information on such programs in your area.
  • Mix with Unpalatable Substance (Optional): If there are no specific disposal instructions provided, you can mix the medication with an unpalatable substance, like cat litter or coffee grounds, and place it in a sealed container or bag before throwing it away. This can help deter accidental ingestion by humans or animals.

In case of emergency/overdose

In case of an emergency or suspected overdose of Mestinon, seek immediate medical attention or contact your local poison control center at 1-800-222-1222 (in the United States). Signs of an overdose may include:

  • Severe muscle weakness
  • Excessive salivation
  • Sweating
  • Increased muscle twitching or cramps
  • Difficulty breathing
  • Nausea and vomiting
  • Diarrhea
  • Blurred or double vision
  • Seizures

What other information should I know

  • Regular Follow-Up: It’s crucial to have regular follow-up appointments with your healthcare provider while taking Mestinon. They will monitor your progress, adjust your dosage if necessary, and discuss any concerns or side effects.
  • Inform Healthcare Providers: Make sure all healthcare providers you see are aware that you are taking Mestinon, as it may interact with other medications or affect medical procedures.
  • Driving and Operating Machinery: Mestinon may cause dizziness or affect your ability to concentrate. Be cautious when driving or operating heavy machinery until you are certain about how the medication affects you.
  • Inform About Allergies: Inform your healthcare provider if you have allergies to any medications or if you experience any allergic reactions while taking Mestinon.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of Mestinon with your healthcare provider, as special considerations may apply.

Always follow your healthcare provider’s instructions for taking Mestinon and reach out to them if you have any questions or concerns about the medication’s storage, disposal, or any other aspect of your treatment.

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