Patient leaflet - Pyridostigmine, 60 mg tablets
1. What Pyridostigmine Tablets are and what they are used for
Pyridostigmine belongs to a group of medicines known as anticholinesterase inhibitors. It helps messages pass from the brain to the muscles so that the muscle works properly.
Pyridostigmine is used to treat:
myasthenia gravis, a condition that prevent messages
reaching the muscles from the brain. The muscles quickly become tired and weak and, in severe cases may become paralysed. This medicine helps the messages to get through more easily.
- some rare forms of constipation (paralytic ileus)
- the inability to pass urine after an operation.
2. Before you take Pyridostigmine Tablets
Do not take Pyridostigmine Tablets if you:
are allergic (hypersensitive) to pyridostigmine bromide or
any of the other ingredients.
are constipated or cannot urinate, unless your doctor has
told you to use this medicine.
Take special care with Pyridostigmine Tablets and consult your doctor if you:
- suffer from asthma
- have recently had coronary thrombosis (heart attack)
- have a slow heart beat
- have low blood pressure
- have a stomach ulcer
- have epilepsy
- have Parkinson's disease
- have kidney problems
suffer from a condition called vagotonia (a condition where
over activity of the vagus nerve causes symptoms such as slow heart rate, low blood pressure, constipation, sweating and painful muscle spasms)
- have an overactive thyroid gland
- have had an operation to remove your thymus gland.
Take special care with Pyridostigmine Tablets
There is no evidence to suggest that pyridostigmine has any special effects on elderly patients. However, tell your doctor if you are elderly and have any heart condition.
Taking other medicine
Take special care with Pyridostigmine Tablets and consult your doctor if you are taking any other medicines including those not prescribed by your doctor. This is extremely important, as using more than one medicine at the same time can strengthen or weaken the effect of the medicine. In particular, tell your doctor if you are taking any of the following medicines:
- Medicines containing methylcellulose
- Antibiotics
- Medicines to treat an irregular heart beat
- Other medicines that interfere with transmission between nerves and muscles
The following medicines can prevent your tablets from working:
- Antimuscarinics e.g. atropine, hyoscine
Medicines used to relax muscles during surgery e.g.
pancuronium, vencuronium
The following medicines can increase the effect of your tablets:
- Steroids
- Other muscle relaxants e.g. suxamethonium
- Immunosuppressant drugs
Please tell your doctor or pharmacist if you are taking or have recently taken any other Medicines including medicines obtained without a prescription.
Taking Pyridostigmine Tablets with food or drink
Pyridostigmine Tablets should be taken 30 to 60 minutes before a meal.
Pregnancy and breast-feeding
The safety of pyridostigmine for use during
pregnancy has not been established. Hence, it
should be taken only if your doctor advises to do so.
Pyridostigmine passes into breast milk in small amounts. Your doctor will decide if it is appropriate for you to continue taking pyridostigmine while breast-feeding.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
The effects of pyridostigmine on the ability to drive and operate machinery have not been established. Hence do not drive or use machinery when you are on Pyridostigmine Tablets unless you are sure your judgement and co-ordination are not affected.
Important information about some of the ingredients of Pyridostigmine Tablets
Pyridostigmine Tablets contain lactose. If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicinal product.
3. How to take Pyridostigmine Tablets
Follow your doctor’s directions about when and how to take your tablets and look at the label on the carton. Your pharmacist will also help if you are not sure.
You should try to take your medicine so that it can work when your muscles are needed most, for example, when you get up and at meal times. The tablets take 30 to 60 minutes to start working after you have taken them so you should try to take your first dose of the day when you get up and other doses about 30 to 60 minutes before a meal.
Swallow the tablets with water or another non-alcoholic drink. If you have difficulty swallowing, you can break the tablets into pieces.
The dose will depend on your illness and on your age as follows:
For myasthenia gravis:
The normal adult dose is ½ to 2 tablets (30 to 120 mg pyridostigmine) to be taken five to six times daily or higher doses if needed as recommended by your doctor.
If you have myasthenia gravis, the effect of each dose should last about four hours during the day and about six hours at night.
For paralytic ileus and post-operative inability to pass urine:
The normal adult dose is 1 to 4 tablets (60 to 240 mg pyridostigmine) daily and for children ¼ to 1 tablet (15 to 60 mg) daily, depending on the needs of the patient.
For children
For children under 6 years the usual dose is ½ tablet (30 mg). For children aged 6 to 12 years, the usual starting dose is 1 tablet (60 mg). The doctor will then gradually increase the dose until maximum improvement is seen. In children the total dose per day is usually 30 to 360 mg.
If you take more Pyridostigmine Tablets than you should
It is important to stick to the dose on the label of the medicine. If you or someone else swallows several of these tablets all together, contact your doctor or nearest hospital emergency department immediately. Always take any tablets left over with you and also the box, as this will allow easier identification of the tablets.
If you forget to take Pyridostigmine Tablets
If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose do not take a double dose to make up for a forgotten dose, just carry on as before.
If you stop taking Pyridostigmine Tablets
It is important that you keep taking these tablets until your doctor tells you to stop.
Do not change the prescribed dose yourself. If you think the effect of your medicine is too weak or too strong, talk to your doctor. Always tell your doctor if you want to stop taking the medicine.
If you have any further questions on the use of this product ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, Pyridostigmine Tablets can have side effects although not everybody gets them.
The following side effects have been reported:
Side effects of unknown frequency:
- sensitivity to drug
- temporary loss of consciousness
- hypotension, Flushing
- blurred vision
- visual disturbance, producing more tears than usual
an irregular heart beat, heart block, low blood
pressure, fainting
producing more phlegm than usual combined with
constriction of the airways
feeling sick, vomiting, diarrhoea, stomach discomfort
pain and cramps, producing more saliva than usual
- rash
- excessive sweating
muscle weakness and twitching, shaking, muscle
cramps
- sudden, compelling urge to urinate.
Because these symptoms may be an indication of cholinergic crisis, the physician should be notified immediately to clarify the diagnosis. If you are concerned about any of these effects talk to your doctor or pharmacist.
Reporting of side effects:
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Pyridostigmine Tablets
- Keep this medicine out of the reach and sight of children..
Do not use Pyridostigmine Tablets after the expiry date.
The expiry date refers to the last day of the month. Expiry date can be found on the bottle label and carton.
- Store your tablets in the original container. Do not store above 25°C.
- Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6. Further information
What Pyridostigmine Tablets contain
The name of your medicine is Pyridostigmine 60 mg Tablets.
The active substance in your tablet is pyridostigmine bromide. Each tablet contains 60mg of pyridostigmine bromide. Other ingredients are silicon dioxide, lactose monohydrate, maize starch, purified talc and magnesium stearate.
What Pyridostigmine Tablets look like and contents of the pack
Pyridostigmine 60 mg Tablets are white to off white, flat faced, round, bevelled edges, uncoated tablet with cross scoring on one side and debossed ‘NM’ on the other side.
Pyridostigmine 60 mg Tablets are supplied in Type III amber glass bottle with PP child-resistant closure or white opaque HDPE bottle, containing HDPE desiccant (silica gel) canister, with a PP child-resistant closure. Each bottle contains 200 tablets.
Marketing Authorisation Holder and Manufacturer
Marketing authorisation holder:
Teva UK Limited,
Ridings Point,
Whistler Drive,
Castleford,
WF10 5HX,
United Kingdom
Manufacturer:
Actavis Group PTC ehf
Dalshraun 1,
220 Hafnarfjörður,
Iceland
This leaflet was last revised in Jan 2024.
PL 00289/2298
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