Pyridostigmini bromidum

Medicine
Related diseases

Description

Pyridostigmini bromidum medication is an acetylcholinesterase inhibitor that works weaker, slower, and longer compared to neostigmine, causing fewer muscarinic effects.

Indications

  • Severe myasthenia gravis

Contraindications

  • Hypersensitivity to the drug or any of its excipients
  • Intestinal or urinary tract obstruction
  • Myotonia

Dosage

Adults and Children Over 12 Years:

  • Oral administration: 30-120 mg at appropriate intervals
  • Usual daily dose: 0.3-1.2 g (for children from 12 years: 300-600 mg)
  • Doses higher than 450 mg per day are not recommended due to the risk of decreased acetylcholine receptor density
  • If a dose higher than 360 mg per day is needed, consider using an immunosuppressant as well

Children (1 Month to 12 Years):

  • Oral administration: Initially 1-1.5 mg/kg per day, gradually increasing to 7 mg/kg per day (taken in 6 doses)
  • Usual daily dose: 30-360 mg

Adverse Reactions

  • Nausea, vomiting, salivation, diarrhea, abdominal cramps
  • In case of overdose: bronchospasm, increased bronchial secretion, sweating, tearing, involuntary defecation and urination, miosis, nystagmus, bradycardia, heart block, arrhythmia, hypotension, psychomotor agitation, CNS stimulation, weakness, fasciculation, and paralysis

Pregnancy

  • Possible teratogenic effects. Use only when absolutely necessary.

Breastfeeding

  • A small amount passes into breast milk. It is believed that such an amount should not be harmful.

Warnings

  • Use with caution in cases of bronchial asthma (some manufacturers do not recommend use)
  • Bradycardia, arrhythmia, recent myocardial infarction, epilepsy, hypotension, Parkinsonism, vagotonia, peptic ulcer, hyperthyroidism
  • Sometimes additional administration of atropine or another antidote to weaken muscarinic effects may be necessary

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė