pyridostigmine bromide at a glance
Medicine class
Reversible cholinesterase inhibitor
Main role
Symptom relief in myasthenia gravis
What is pyridostigmine bromide used for?
The selected product is licensed for:
Symptomatic treatment of myasthenia gravis.
Paralytic ileus, where bowel movement has stopped without a mechanical blockage.
Post-operative urinary retention.
How does pyridostigmine bromide work?
Pyridostigmine temporarily blocks acetylcholinesterase, the enzyme that breaks down acetylcholine. This leaves more acetylcholine available at nerve–muscle junctions, helping muscles respond to nerve signals. It improves symptoms but does not treat the autoimmune cause of myasthenia gravis.
pyridostigmine bromide preparations and strengths
Tablet
Route: Oral
Strengths: 60 mg
How to take pyridostigmine bromide
Follow the individually prescribed instructions. Tablets are taken by mouth and may be taken with or without food.
Swallow with water or another non-alcoholic drink.
If swallowing is difficult, the scored tablet may be broken into pieces; confirm the intended preparation with a pharmacist or prescriber.
Tell the clinical team if the effect seems inadequate or weakness worsens—do not adjust treatment independently.
pyridostigmine bromide side effects
Common or expected effects
- Nausea, vomiting, diarrhoea or abdominal cramps
- Increased saliva, sweating, tears or chest secretions
- Muscle cramps, twitching, tremor or increased weakness
- Blurred vision or small pupils
- Urinary urgency
Get urgent medical advice
- Difficulty breathing, bronchospasm or inability to clear increased secretions
- Marked or rapidly worsening muscle weakness
- Fainting, severe dizziness or a very slow or irregular heartbeat
- Swelling, widespread hives or other features of a severe allergic reaction
pyridostigmine bromide in pregnancy
Pyridostigmine can be used during pregnancy when needed for myasthenia gravis. Available information has not raised concerns about fetal development, but evidence remains limited and myasthenia can fluctuate during pregnancy. Anyone planning pregnancy or becoming pregnant should arrange early review with their GP, neurologist and maternity team rather than stopping treatment independently.
pyridostigmine bromide while breastfeeding
Only small amounts of pyridostigmine are expected to reach breast milk, and adverse effects in breastfed infants are not expected from the available evidence. Discuss breastfeeding plans with the prescriber, particularly if the baby is premature or unwell or the mother has significant fatigue.
pyridostigmine bromide interactions
Check all prescribed, pharmacy and over-the-counter products because interactions may alter pyridostigmine absorption, neuromuscular function or anaesthetic response.
Methylcellulose-containing products
Methylcellulose can prevent pyridostigmine absorption and may substantially reduce its effect.
Atropine, hyoscine and other antimuscarinics
These oppose pyridostigmine's muscarinic effects and may alter its absorption by slowing the gut.
Non-depolarising muscle relaxants
Pyridostigmine can reduce their muscle-relaxing effect, which is important during anaesthesia.
Common questions about pyridostigmine bromide
Answers are fully visible for fast scanning and source review.
What is pyridostigmine bromide used for?
It is mainly used to improve muscle weakness in myasthenia gravis. It is also licensed for paralytic ileus and post-operative urinary retention.
Does pyridostigmine bromide cure myasthenia gravis?
No. It improves nerve-to-muscle signalling and relieves symptoms but does not remove the autoimmune cause.
Can pyridostigmine bromide make weakness worse?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.