This information sheet answers some of the common questions patients ask about pyridostigmine. Further information can be found in the information leaflet supplied by the manufacturer or from your consultant neurologist, specialist nurse or pharmacist.

Why Have I Been Prescribed This Medication?

Pyridostigmine is used in myasthenic disorders to improve muscle strength.

How Does it Work?

Pyridostigmine does not cure myasthenia. It temporarily improves nerve-muscle transmission which helps muscle strength.

How Long Does It Take To Work?

It should take 30 to 60 minutes to start working after you have taken them. The effect of each dose should last about four hours.

What Dose Do I Take?

The dose of pyridostigmine depends on your needs. The typical maximum dose is six tablets (each 60mg) a day, divided up to be taken several times during the day. If you feel you need more than the usual dosage range, please seek the advice of your consultant neurologist. In children, the dosage is dependent on weight.

How Do I Take It?

Pyridostigmine is available in tablet form. You should always take the medicine as directed by your consultant neurologist.

• Always read the manufacturers information leaflet as well as this one if possible. There may be additional information there that you could find useful.
• The tablets should be taken with water. If you have difficulty swallowing, the tablets can be broken into pieces.
• You should take the medicine so that it can work when your muscles are needed most. For example when you get up and about 30 to 60 minutes before a meal.
• Never take more than the dose prescribed by your consultant neurologist. If you or someone else has taken an overdose of pyridostigmine contact your GP or got to the nearest A&E immediately, taking the medicine container with you.

How Long Will I Be Taking It For?

Does Pyridostigmine Interfere With My Other Medicines?

Pyridostigmine rarely interacts with other medicines. It is often the case that other medications exacerbate the myasthenia by other means. You should tell your consultant neurologist and GP which medicines you are taking before starting pyridostigmine.

It is safe to drink alcohol in moderation whilst taking pyridostigmine.

Can Taking Pyridostigmine Cause Any Side Effects?

All medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicines. Particularly during the early weeks of treatment. Pyridostigmine may cause the following side effects:

• Stomach upset such as abdominal cramps, feeling or being sick and diarrhoea
• Visual disturbances, producing more tears than usual
• Producing more phlegm and saliva than usual
• Skin rash
• Excessive sweating
• Muscle cramps and twitching
• Sudden urges to urinate
• Exacerbation of asthma

If you get side effects, talk to your neurologist or you GP. Anti-cholinergic drugs can be prescribed to counteract some of the side effects.

Do I Need Special Checks Whilst on Pyridostigmine?

You do not need any special checks whilst on pyridostigmine.

What Happens If I Forget To Take a Dose

If you miss a dose, take it as soon as your remember. If your next dose is due within two hours, take a single dose and skip the next. Do not take more than your prescribed dose as that may cause muscle weakness.

Is Pyridostigmine OK in Pregnancy and Breastfeeding?

There is no evidence to suggest that pyridostigmine is harmful during pregnancy or breastfeeding. However, if you are planning on becoming pregnant, it is recommended that you discuss this with your neurologist.

You can find more information about pregnancy and myasthenia here.

Storage of Pyridostigmine

Please ensure you keep a sufficient supply of pyridostigmine and it is within date. Store pyridostigmine in a closed container in a cool dry place and protect from sunlight.

Keep all medicines out of the reach of children

Never give any medication prescribed to you to anyone else

It may harm them even if their symptoms are the same as yours

Steroids