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Mestinon Syrup (Generic Pyridostigmine)

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Why is this medication prescribed?

Mestinon Syrup is a brand name for a medication called pyridostigmine bromide. It is primarily prescribed for the treatment of a medical condition known as myasthenia gravis. Myasthenia gravis is an autoimmune disorder that affects the neuromuscular junction, leading to muscle weakness and fatigue. Pyridostigmine, the active ingredient in Mestinon, helps improve muscle strength and function in people with myasthenia gravis by inhibiting the breakdown of acetylcholine, a neurotransmitter that plays a crucial role in muscle contractions.

How should this medicine be used?

Here are some general guidelines for using Mestinon Syrup:

  • Dosage: The dosage of Mestinon Syrup can vary depending on the individual’s age, weight, and the severity of their myasthenia gravis. It is essential to follow your healthcare provider’s instructions and the dosing schedule they provide.
  • Administration: Mestinon Syrup is usually taken orally, and it may be taken with or without food. The syrup form makes it easier to measure and administer the appropriate dose, especially for individuals who have difficulty swallowing pills.
  • Timing: It is typically taken at evenly spaced intervals throughout the day to maintain a consistent level of the medication in the bloodstream. Your healthcare provider will determine the specific dosing schedule that works best for you.
  • Follow Instructions: Always follow your healthcare provider’s instructions regarding the dosage and frequency of Mestinon Syrup. Do not change the dose or stop taking the medication without consulting your doctor.
  • Monitoring: Your healthcare provider may adjust your dosage over time based on your response to the medication and any potential side effects. Regular check-ups and monitoring of your myasthenia gravis symptoms are essential.
  • Do not double dose: If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double dose to make up for a missed one.
  • Side Effects: Like all medications, Mestinon Syrup can cause side effects. Common side effects may include nausea, abdominal cramps, diarrhea, excessive salivation, sweating, and muscle twitching. If you experience severe side effects or allergic reactions (e.g., rash, difficulty breathing), seek immediate medical attention.
  • Interactions: Inform your healthcare provider of all other medications, supplements, or medical conditions you have, as Mestinon may interact with certain drugs or exacerbate certain medical conditions.

It’s crucial to consult with your healthcare provider or a pharmacist for detailed instructions on how to use Mestinon Syrup, as individual dosing requirements and potential interactions can vary. This information is intended as a general guideline and should not replace professional medical advice.

Other uses for this medicine

Mestinon Syrup is primarily used to treat myasthenia gravis. It is not typically used for other conditions. Any use of this medication for conditions other than those prescribed by your healthcare provider should be discussed with them.

What special precautions should I follow?

When using Mestinon Syrup or any medication, it’s essential to take certain precautions to ensure safety and effectiveness:

  • Allergies: Inform your healthcare provider if you are allergic to pyridostigmine bromide or any other medications, as well as any other allergies you may have.
  • Medication Interactions: Discuss all other medications, supplements, and herbal products you are taking with your healthcare provider. Mestinon may interact with certain medications, including other neuromuscular blocking agents, cholinergic drugs, and some anticholinergic drugs.
  • Medical Conditions: Inform your healthcare provider of any medical conditions you have, especially asthma, epilepsy, heart conditions, gastrointestinal issues, or urinary tract problems, as these may affect your response to Mestinon.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of using Mestinon with your healthcare provider. It may be used during pregnancy or breastfeeding if the benefits outweigh the potential risks.
  • Side Effects: Be aware of potential side effects, which may include gastrointestinal symptoms, excessive salivation, sweating, and muscle twitching. Report any unusual or severe side effects to your healthcare provider.
  • Dosing: Take the medication as prescribed and follow your healthcare provider’s instructions carefully. Do not change the dose or stop taking it without consulting your doctor.
  • Driving and Operating Machinery: Mestinon may cause dizziness or affect your ability to drive or operate heavy machinery. Use caution until you know how the medication affects you.
  • Regular Monitoring: Your healthcare provider will likely monitor your progress while taking Mestinon to ensure it is effective and safe for you.

Always consult with your healthcare provider for specific guidance and precautions related to your individual health and medical history when using Mestinon Syrup or any other medication.

What special dietary instructions should I follow?

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

  • Food: You can take Mestinon Syrup with or without food. However, taking it with food may help reduce stomach upset.
  • Avoid Alcohol: Limit or avoid alcohol consumption while taking Mestinon, as alcohol can worsen side effects such as dizziness or drowsiness.

What should I do if I forget a dose?

If you forget to take a dose of Mestinon Syrup, follow these steps:

  • Take it as soon as you remember: If it’s not too close to your next scheduled dose, take the missed dose as soon as you remember.
  • Skip the missed dose: If it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.
  • Do not double up: Do not take two doses at the same time to make up for the missed one.
  • Notify your doctor: If you frequently forget doses or are unsure about what to do, discuss it with your healthcare provider. They can provide guidance on managing missed doses.

What side effects can this medication cause?

Mestinon Syrup (pyridostigmine) can cause side effects, as with any medication. It’s important to be aware of these potential side effects and discuss them with your healthcare provider. Common side effects of Mestinon Syrup may include:

  • Gastrointestinal Symptoms: These are among the most common side effects and may include nausea, vomiting, abdominal cramps, diarrhea, or increased salivation.
  • Muscle Twitching: Some individuals may experience muscle twitching or fasciculations.
  • Excessive Sweating: Increased sweating, known as diaphoresis, can occur.
  • Urinary Urgency or Frequency: You might experience a need to urinate more frequently or with a greater sense of urgency.
  • Increased Salivation: Excessive saliva production is a common side effect and can sometimes be bothersome.
  • Dizziness or Fainting: In some cases, Mestinon can cause dizziness, especially when standing up. This can increase the risk of falls.
  • Weakness: Paradoxically, Mestinon can cause muscle weakness, particularly if the dose is too high or taken too frequently.
  • Difficulty Breathing: Although rare, severe adverse reactions can occur, including difficulty breathing or an allergic reaction. Seek immediate medical attention if you experience these symptoms.
  • Bradycardia: In some cases, Mestinon can slow the heart rate, leading to bradycardia (slow heart rhythm). This is more common in individuals with heart conditions.
  • Other Side Effects: Less common side effects may include headache, tremors, changes in taste, and difficulty sleeping.

It’s essential to take Mestinon as prescribed by your healthcare provider and report any side effects promptly. If you experience severe side effects or allergic reactions such as rash, itching, swelling, severe dizziness, or difficulty breathing, seek immediate medical attention.

Your healthcare provider will monitor your response to Mestinon and adjust your dosage if necessary. They can also provide guidance on managing side effects. In some cases, side effects may diminish or become more manageable as your body adjusts to the medication.

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


  • Store at Room Temperature: Keep Mestinon Syrup at room temperature, away from excessive heat and moisture. Avoid freezing the medication.
  • Keep Out of Reach of Children: Store the medication in a safe place out of the reach of children and pets, as accidental ingestion can be dangerous.
  • Protect from Light: Some medications can degrade when exposed to light, so it’s a good practice to keep the medication in its original container, which is typically opaque and designed to protect it from light.
  • Check Expiry Date: Ensure that you are using the medication within its stated expiration date. Do not use Mestinon Syrup if it has expired.


  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
  • Consult your healthcare provider or pharmacist on how to safely dispose of unused or expired medications.
  • It’s generally advisable to return any unused or expired medication to a pharmacy or a designated drug take-back program in your area.

In case of emergency/overdose

  • In case of an overdose or if you suspect someone has ingested too much Mestinon Syrup, contact your local poison control center or emergency medical services immediately.
  • Symptoms of overdose can include severe muscle weakness, difficulty breathing, increased salivation, sweating, and other severe side effects. Prompt medical attention is crucial in case of an overdose.

What other information should I know

  • Follow Prescribing Instructions: Always take Mestinon Syrup as prescribed by your healthcare provider. Do not change the dose or frequency without consulting them.
  • Regular Check-Ups: Your healthcare provider may require regular check-ups to monitor your condition and adjust your medication as needed.
  • Inform Healthcare Providers: Inform all healthcare providers involved in your care about your use of Mestinon, including dentists and surgeons, as it may interact with other medications or affect anesthesia.
  • Carry Medication Information: Consider carrying a medical alert card or wearing a medical alert bracelet to inform healthcare providers about your medication if you have a medical emergency.
  • Avoid Alcohol: Alcohol can interact with Mestinon and increase the risk of side effects, so it’s generally recommended to limit alcohol consumption or avoid it altogether while taking the medication.
  • Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of Mestinon with your healthcare provider, as they can provide guidance on its safety and potential risks.

Always consult your healthcare provider or pharmacist if you have specific questions or concerns about Mestinon Syrup, its storage, usage, or any potential interactions with other medications you may be taking. They can provide personalized guidance based on your medical history and individual needs.

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