Pyridostigmine Bromide
Other CNS Drugs · Anticholinesterase
Indications
Myasthaenia gravis. Paralytic ileus.
Dosage
Adults: Myasthaenia gravis: Usually 300-1200 mg daily in divided doses. Paralytic ileus: 60-240 mg as required. Children: Treatment of Myasthaenia gravis: Neonate, initially 1-1.5 mg/kg, increased gradually to max 10 mg, repeated throughout the day, give 30-60 minutes before feeds; 1 mth-12 yr, initially 1-1.5 mg/kg/day, increased gradually to 7 mg/kg/day in 6 divided doses; usual total daily dose 30-360 mg; 12-18 yr, 30-120 mg, repeated throughout the day; usual total daily dose 300-600 mg. Consider immunosuppressant therapy if total daily dose exceeds 360 mg, down-regulation of acetylcholine receptors possible if total daily dose exceeds 450 mg.
Adverse Effects
Nausea, salivation, diarrhoea, colic.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Intestinal or urinary obstruction. Precautions: Bronchial asthma, cardiac disease, vagotonia, epilepsy, Parkinsonism, bradycardia, recent coronary occlusion, hypotension, peptic ulcer. Renal disease.
Interactions
Depolarising muscle relaxants, cyclopropane, halothane, antimuscarinics.
Advice to Patient
Take with meals. Take extended release tablets at bedtime. Do not chew or crush extended release tablets. Contact prescriber if there is acute headache, dizziness or depression, lack of sleep, unrelieved diarrhoea, increased fatigue, stomach discomfort, increased salivation/tearing/sweating/urination, chest pain or palpitations, flushing of skin, change in vision, blurred vision, increased muscle/body/joint pain, difficulty in breathing, wheezing. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Change position slowly from sitting or lying to standing. Carry medical identification card mentioning patient's condition and names of medicines.
Pharmacokinetics
Onset of action: Recovery from vincristine neurotoxicity: onset of action: 1 to 2 weeks. Myasthenia gravis: Oral: Within 30 minutes; IM: 15 to 30 minutes; IV: Within 2 to 5 minutes. Duration: Oral: 3 to 4 hours in the daytime; IM, IV: 2 to 3 hours. Absorption: Oral: Very poor. Metabolism: Hepatic and at tissue site by cholinesterases. Bioavailability: 10% to 20%. Half-life elimination: Oral: 1 to 2 hours; renal failure: Approx. 6 hours; IV: Approx. 1.5 hours. Time to peak, plasma: Oral: 1 to 2 hours. Excretion: Urine (80% to 90% as unchanged drug).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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