Pyridostigmine

Pyridostigmine is used to treat myasthenia gravis. Pyridostigmine is in a class called cholinergic agents. It works by increasing the amount of certain natural substances in the body to improve nerve and muscle activity.

Pyridostigmine comes as a regular tablet, an extended-release (long-acting) tablet, and a solution (liquid) to take by mouth. It is taken once, twice, or several times a day, depending on the formulation being used. Your doctor may change your dose, depending on how you respond to the drug.

Take pyridostigmine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release tablets whole; do not chew or crush them.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking pyridostigmine,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you ha
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking pyridostigmine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had blockage of the intestines or bladder. Your doctor will probably tell you not to take pyridostigmine.
• tell your doctor if you have or have ever had heart or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pyridostigmine, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. You will need to allow 6 hours between doses of the extended-release tablet. Do not take a double dose to make up for a missed one.

Pyridostigmine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea, diarrhea, vomiting
• drooling
• cold sweats
• blurred vision
• increased urge to urinate
• muscle cramps or weakness

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• severe itching, skin rash, or hives
• slurred speech
• confusion
• seizures
• difficulty breathing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not remove the desiccant (drying agent) packet that comes in the container of tablets and extended-release tablets. Do not swallow the desiccant packet.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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