Mestinon SR (Pyridostigmine)

Indications

Mestinon SR is an oral medication used for the symptomatic treatment of myasthenia gravis, a muscle disease that causes extreme muscle fatigue.

Mestinon SR contains the active ingredient pyridostigmine bromide and is available in slow-release tablets, with a strength of 180 mg. It is a cholinesterase inhibitor that works by inhibiting the enzyme acetylcholinesterase (AChE) from breaking down acetylcholine (ACh), thereby increasing the concentration of ACh in the neuromuscular junction and improving muscle strength.

Use and Dosage

Mestinon SR comes in the form of an extended-release tablet, with a strength of 180 mg, which is taken orally by mouth. Mestinon SR is typically taken once a day, and it should be taken at the same time each day. You should swallow the tablet whole, without crushing or chewing it. Crushing or chewing the tablet can destroy the sustained-release mechanism and lead to too much medication being released at once. The extended-release formulation of pyridostigmine allows for a sustained release of the medication into the body over a longer period, which can be beneficial for patients with myasthenia gravis who require long-term treatment to maintain muscle strength.

The recommended dosage of Mestinon SR for myasthenia gravis ranges from 180-540 mg once daily or every 12 hours. The dose should be spaced out to provide maximum relief and not exceed 1.5 grams per day. Note that the dose of Mestinon SR should be taken as directed by a doctor and may need to be adjusted based on individual patient needs and response to treatment.

Take the medication regularly at the same time each day to get the most benefit. Do not exceed your prescribed dose or take it more often or for longer than needed as it may increase the risk of side effects. The moisture may cause discoloration of the tablet forms of the medication, but it doesn't affect its efficacy.

Side Effects

Common Side Effects of Mestinon SR (Pyridostigmine):

• Abdominal cramps
• Decreased pupil size
• Diarrhea
• Increased saliva/mucus
• Increased sweating or cold sweat
• Increased urination
• Nausea
• Pale skin
• Rash or itching
• Upset stomach
• Vomiting
• Warmth or tingly feeling
• Watery eyes

Serious Side Effects of Mestinon SR (Pyridostigmine):

• Dizziness
• Extreme muscle weakness
• Headache
• Muscle cramps or twitching
• New or increased difficulty swallowing
• New or increased muscle cramps/weakness/twitching
• Severe vomiting
• Shortness of breath
• Slow heartbeat
• Vision problems

Forms and Strength

Mestinon SR (Pyridostigmine) is available in the following forms and strength:

Mestinon SR: ER Tablet

• 180 mg

Cautions

• Pyridostigmine should be used with caution in patients with asthma, bradycardia, hypotension, or gastrointestinal or urinary tract obstruction.
• Pyridostigmine may interact with other medications, including anticholinergic drugs, cholinergic agonists, and neuromuscular blocking agents.
• Pyridostigmine may cause side effects such as diarrhea, abdominal cramps, nausea, vomiting, increased saliva production, sweating, blurred vision, and muscle weakness.
• Pyridostigmine should be used with caution in patients with liver or kidney disease, as dosage adjustments may be necessary.
• Pyridostigmine may affect blood sugar levels and should be used with caution in patients with diabetes.
• Pyridostigmine may interact with anesthesia, and patients should inform their healthcare provider if they are taking pyridostigmine before undergoing surgery.

Frequently Asked Questions (FAQ)

Can Mestinon SR interact with other medications?

Pyridostigmine may interact with other medications, including anticholinergic drugs, cholinergic agonists, and neuromuscular blocking agents. Inform your healthcare provider of any medications you are taking before starting Mestinon SR.

Can Mestinon SR be used during pregnancy or breastfeeding?

There is limited information available about the safety of Mestinon SR during pregnancy or breastfeeding. Discuss any potential risks and benefits with a healthcare provider before starting this medication.

How often should I take pyridostigmine?

The dosing schedule for pyridostigmine varies depending on the individual and the severity of their myasthenia gravis. Generally, it is taken multiple times per day, often with food.

Resources

• https://www.webmd.com/drugs/2/drug-3740/mestinon-oral/details
• https://www.rxlist.com/mestinon-drug.htm
• https://medlineplus.gov/druginfo/meds/a682229.html
• https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=013a6524-6eb9-4dbf-b29c-9aec2f40d2d0&type=display
• https://pdf.hres.ca/dpd_pm/00026983.PDF
• https://www.uniprix.com/en/drug-lexicon/00869953/mestinon-sr