Mestinon

Mestinon (Pyridostigmine) is used for treating myasthenia gravis.

Product dosage: 60mg
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30	2.50 $	74.88 $ (0%)	🛒 Add to cart
60	2.07 $	149.76 $ 124.02 $ (17%)	🛒 Add to cart
90	1.94 $	224.64 $ 174.33 $ (22%)	🛒 Add to cart
120	1.86 $	299.52 $ 223.47 $ (25%)	🛒 Add to cart
180	1.79 $	449.28 $ 322.92 $ (28%)	🛒 Add to cart
270	1.75 $ Best per pill	673.92 $ 471.51 $ (30%)	🛒 Add to cart
Synonyms Amiasten Becilan Distinon Dostirav Piridostigmina Pyridostigminum Regonol

Mestinon (pyridostigmine bromide) is a first-line acetylcholinesterase inhibitor specifically formulated for the symptomatic management of myasthenia gravis. It operates by enhancing cholinergic transmission at neuromuscular junctions, directly countering the muscle weakness and fatigue characteristic of the disease. This agent is a cornerstone of therapeutic regimens, offering patients improved voluntary muscle control and a significant enhancement in quality of life. Its well-established efficacy and safety profile make it a fundamental choice for neurologists and specialists in neuromuscular disorders.

Features

• Active pharmaceutical ingredient: Pyridostigmine Bromide
• Available in oral formulations: 60 mg scored tablets and 180 mg extended-release tablets
• Also available as a syrup formulation (60 mg/5 mL) for precise dosing or for patients with swallowing difficulties
• Rapid onset of action, typically within 30 to 60 minutes for standard tablets
• Duration of effect for standard tablets is approximately 3 to 4 hours; extended-release formulation provides a longer duration
• Cholinesterase inhibitor pharmacologic class

Benefits

• Significantly improves muscle strength, reducing the debilitating weakness associated with myasthenia gravis.
• Enhances endurance for daily activities, allowing for greater functional independence and improved quality of life.
• Alleviates specific symptoms such as ptosis (drooping eyelids), diplopia (double vision), and difficulties with chewing, swallowing, and speech.
• Provides a predictable and titratable response, allowing clinicians to tailor therapy to individual patient needs.
• Serves as a diagnostic tool in the Tensilon test (edrophonium chloride test) for confirming myasthenia gravis.

Common use

Mestinon is primarily indicated for the treatment of myasthenia gravis, an autoimmune disorder characterized by antibodies attacking acetylcholine receptors at the neuromuscular junction, leading to muscle weakness and fatigue. It is used for both diagnostic purposes and for chronic symptomatic management. It may also be used in other medical situations, such as for the reversal of non-depolarizing neuromuscular blocking agents after surgery, under strict medical supervision, and off-label for the treatment of orthostatic hypotension or certain types of nerve agent poisoning.

Dosage and direction

Dosage is highly individualized based on the patient’s response and tolerance. The initial dosage for adults is typically 60 mg (one standard tablet) taken orally 3 to 4 times daily. The frequency and timing of doses are often adjusted to coincide with periods of greatest fatigue (e.g., before meals to aid chewing and swallowing). The extended-release 180 mg tablet is usually administered at bedtime to control symptoms through the night and upon waking. It is crucial that the extended-release tablets are swallowed whole and never crushed or chewed. Dosage for pediatric patients is based on body weight and must be determined by a specialist. Administration with food or milk can mitigate gastrointestinal side effects.

Precautions

Patients should be closely monitored for both under-dosing (return of myasthenic weakness) and over-dosing (cholinergic crisis). Use with extreme caution in patients with asthma, bradycardia, arrhythmias, or recent coronary occlusion. It may increase urinary retention in patients with prostatic hypertrophy. Patients with renal impairment may require dosage adjustments due to reduced drug clearance. Pyridostigmine bromide can cause dizziness, so patients should be advised against operating machinery or driving until they know how the medication affects them.

Contraindications

Mestinon is contraindicated in patients with known hypersensitivity to pyridostigmine bromide or any components of the formulation. Its use is also contraindicated in cases of mechanical intestinal or urinary obstruction, a history of which is a critical factor to rule out before initiation of therapy.

Possible side effect

Common side effects are primarily muscarinic and are often dose-related. They include:

• Nausea, vomiting, diarrhea, abdominal cramps, and increased salivation
• Increased sweating and lacrimation
• Miosis (pupillary constriction)
• Bradycardia (slow heart rate) and a drop in blood pressure
• Increased bronchial secretions and bronchospasms
• Muscle cramps, fasciculations, and weakness (which can be a sign of overdose) Less common but serious side effects can indicate cholinergic crisis and require immediate medical attention.

Drug interaction

Mestinon has several important drug interactions:

• Other cholinesterase inhibitors (e.g., donepezil, rivastigmine): Increased risk of cholinergic side effects.
• Anticholinergic agents (e.g., atropine, glycopyrrolate): May antagonize the beneficial effects of Mestinon and are used to treat its side effects.
• Corticosteroids: Initiation of corticosteroid therapy may transiently worsen myasthenic weakness, potentially requiring Mestinon dosage adjustment.
• Aminoglycoside antibiotics, magnesium salts, quinidine, procainamide: These can antagonize neuromuscular transmission and potentially decrease the efficacy of Mestinon.
• Succinylcholine: Mestinon will potentiate and prolong the depolarizing neuromuscular blockade of succinylcholine.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should never double the dose to make up for a missed one, as this significantly increases the risk of a cholinergic crisis.

Overdose

Overdose with Mestinon leads to a cholinergic crisis, characterized by severe muscarinic and nicotinic effects. Symptoms include severe nausea/vomiting/diarrhea, profuse sweating and salivation, bradycardia, hypotension, bronchospasm, increased bronchial secretions, muscle weakness (often initially worsening in the muscles requiring treatment), and fasciculations. This is a medical emergency. Treatment involves immediate discontinuation of Mestinon, supportive respiratory care, and administration of atropine sulfate intravenously to counteract muscarinic effects. Note: Differentiation between myasthenic crisis (under-treatment) and cholinergic crisis (over-treatment) can be difficult and often requires a Tensilon test in a controlled hospital setting.

Storage

Store Mestinon tablets and syrup at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. Protect from light, moisture, and excessive heat. Keep all medications out of the reach of children and pets. Do not use beyond the expiration date printed on the packaging.

Disclaimer

This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your neurologist or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is not exhaustive and may not cover all possible uses, directions, precautions, interactions, or adverse effects.

Reviews

• “As a neurologist specializing in neuromuscular disorders, Mestinon remains the bedrock of symptomatic therapy for my myasthenia gravis patients. Its predictable pharmacokinetics allow for fine-tuning to a patient’s specific daily needs.” – Dr. E. Vance, MD, Neurology.
• “The difference it made for my ptosis and ability to swallow was almost immediate. It gave me back a significant part of my day. Dosing timing is key, and my doctor helped me find the perfect schedule.” – Patient, 48.
• “While the GI side effects were challenging at first, taking it with food completely resolved the issue. It’s a lifeline for managing my muscle fatigue.” – Patient, 34.
• “The availability of both immediate and extended-release formulations provides crucial flexibility in managing both daytime function and nighttime/early morning symptoms, which are often a major challenge for patients.” – Dr. A. Sharma, PharmD.