Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Mestinon; Belgium: Mestinon; Bulgaria: Kalymin; Cyprus: Mestinon; Czech Republic: Mestinon; Denmark: Mestinon; Estonia: Kalymin; Finland: Mestinon; France: Mestinon, Pyridostigmine; Germany: Kalymin, Mestinon, Pyridostigmin; Greece: Mestinon; Hungary: Mestinon; Ireland: Mestinon, Pyridostigmine; Italy: Mestinon; Luxembourg: Mestinon; Netherlands: Mestinon; Poland: Brostagin, Mestinon; Portugal: Mestinon; Romania: Mestinon; Slovakia: Mestinon; Spain: Mestinon; Sweden: Mestinon; UK: Mestinon.

North America

Canada: Mestinon; USA: Mestinon, Pyridostigmine, Regonol.

Latin America

Argentina: Mestinon; Brazil: Mestinon; Mexico: Mestinon.


Japan: Mestinon.

Drug combinations


Pyridostigmine Bromide: C~9~H~13~BrN~2~O~2~. Mw: 261.12. (1) Pyridinium, 3-[[(dimethylamino)carbonyl]oxy]-1-methyl-, bromide; (2) 3-Hydroxy-1-methylpyridinium bromide dimethylcarbamate. CAS-101-26-8; CAS-155-97-5 (pyridostigmine).

Pharmacologic Category

Parasympathomimetic (Cholinergic) Agents; Acetylcholinesterase Inhibitor. (ATC-Code: N07AA02).

Mechanism of action

Inhibits destruction of acetylcholine by acetylcholinesterase, which facilitates transmission of impulses across myoneural junction.

Therapeutic use

Symptomatic treatment of myasthenia gravis. Antidote for nondepolarizing neuromuscular blockers. Pre-treatment for Soman nerve gas exposure (military use).

Pregnancy and lactiation implications

Safety not established for use during pregnancy. Potential benefit to mother should outweigh potential risk to fetus. Enters breast milk. Neonates of myasthenia gravis mothers may have difficulty in sucking and swallowing (as well as breathing).

Unlabeled use


Hypersensitivity to pyridostigmine, bromides, or any component of the formulation. Gastrointestinal or genitourinary obstruction.

Warnings and precautions

For brief or prolonged periods, anticholinesterase insensitivity can develop. Overdosage may result in cholinergic crisis. Hypersensitivity reactions might occur. Use with caution in asthma, in bradycardia or cardiac arrhythmias, in GI disease (including peptic ulcer disease), in hyperthyroidism, and in history of seizure disorder. Injection contains 1% benzyl alcohol as preservative (not intended for use in newborns).



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