Myaware share the growing concern regarding the continued disruption to the supply of Propantheline Bromide (Pro-Banthine). We have been consistently contacting the supplier Kyowa Kirin, and two manufacturers in Grunenthal and Haupt Pharma. Unfortunately, some companies have been unresponsive, while others have only confirmed they have no set date for resupply.

To try and mitigate this continued issue, we have been in contact with our medical committee, who have provided the following guidance:

-        If your primary side effect from pyridostigmine use is diarrhoea, you can use any medicine that works to combat this. Examples are; Imodium, Pepto-Bismol, Codeine phosphate, Lomotil (co-phenotrope), and Rifaximin. Most if not all of these medicines will be listed as contraindicated in myasthenia due to being muscle relaxants. With this in mind, please confirm with your GP or neurologist that they are happy for you to take this.

-        If you are experiencing stomach cramps, alternatives to Propantheline Bromide are: Buscopan, Mebeverine, and Oxybutynin. All three again need to be approved by your neurologist before initiating treatment.


In addition, the Community Pharmacy England website has listed the following importers as having a supply of unlicensed Propantheline:

-        Alium Medical

-        Mawdsley’s Unlicensed

-        Target Healthcare


If you are able, please request that your pharmacy or neurologist put in a special-order request for Propantheline 15mg tablets from one of these companies using an FP10 paper. 

Finally, myaware will be preparing a letter for the health secretary to highlight the continued disruption to important supply chains for myasthenia patients nationwide and call on policy makers to act now and make significant improvements to these policies and partnerships.

Visit the Community Pharmacy England  website discussing this shortage.

More information regarding this shortage.