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Mestinon (pyridostigmine)

Indications

• Mestinon is prescribed to help improve muscle strength in patients with myasthenia gravis, a chronic autoimmune neuromuscular disorder that causes muscle weakness and fatigue.
• Mestinon is used to reverse the effects of non-depolarizing muscle relaxants after surgery.

Dosage and Administration

• Take Mestinon exactly as directed by your healthcare provider, which is typically several times a day based on your condition.
• Administer with food or milk to reduce the risk of stomach upset.
• Take Mestinon at the same time each day to maintain steady levels of the medication in your body.
• Swallow the tablets whole.
• Do not crush, chew, or split the tablets to ensure proper dosage delivery.
• Avoid changing your dosage without consulting your healthcare provider, as it can affect the medication’s effectiveness and safety.
• Avoid missing doses; consistently take Mestinon as prescribed to maintain muscle strength and control symptoms.
• Do not take a double dose to make up for a missed dose. Simply take the next dose at the scheduled time.

Mechanism of Action

Mestinon (Pyridostigmine) is an acetylcholinesterase inhibitor. It works by inhibiting the enzyme acetylcholinesterase, which breaks down acetylcholine. By preventing the breakdown of acetylcholine, Mestinon increases the levels of this neurotransmitter at the neuromuscular junction, improving communication between nerves and muscles, and thereby enhancing muscle strength in patients with myasthenia gravis.

Contraindications

• Known Hypersensitivity to Pyridostigmine: Do not take Mestinon if you have a known allergy to Pyridostigmine or any of its components.
• Mechanical Intestinal or Urinary Obstruction: Avoid Mestinon if you have a blockage in your intestines or urinary tract, as it can worsen these conditions.
• Peritonitis: Patients with peritonitis should not use Mestinon.

Side Effects

Common Side Effects:

• Nausea
• Diarrhea
• Abdominal cramps
• Increased saliva production
• Sweating
• Muscle twitching

Serious Side Effects:

• Severe abdominal pain or cramping
• Difficulty breathing
• Irregular heartbeat
• Severe muscle weakness
• Signs of a serious allergic reaction (rash, itching/swelling, severe dizziness, difficulty breathing)

Precautions

• Inform About All Medications: Provide your doctor with a complete list of your current medications to avoid harmful interactions.
• Monitor for Signs of Overdose: Symptoms of overdose may include muscle weakness, severe abdominal cramps, and difficulty breathing. Contact your healthcare provider immediately if these occur.
• Adjust for Kidney Function: Discuss with your doctor if you have kidney problems, as dosage adjustments may be necessary.
• Caution in Asthma or Epilepsy: Use Mestinon with caution if you have asthma or epilepsy, as it may exacerbate these conditions.
• Regular Monitoring: Regular follow-ups with your healthcare provider are necessary to monitor your response to the medication and adjust the dosage if needed.

Storage Instructions

• Keep Mestinon tablets at 68°F to 77°F (20°C to 25°C).
• Store in the original container to protect from moisture and light.
• Ensure that Mestinon is stored in a safe place away from children to prevent accidental ingestion.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2001/15193s18lbl.pdf