Mestinon Timespan Disease Interactions
There are 7 disease interactions with Mestinon Timespan (pyridostigmine).
Cholinesterase inhibitor (applies to Mestinon Timespan) bradycardia
Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias
Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported in patients with and without cardiac abnormalities. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.
References
- Wilcock GK, Surmon D, Forsyth D, Morgan R (1988) "Cholinergic side-effects of tetrahydroaminoacridine." Lancet, 2, p. 1305
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- Baldessarini RJ, Gelenberg AJ (1979) "Using physostigmine safely." Am J Psychiatry, 136, p. 1608-9
- Janowsky DS, Risch SC, Huey LY, Kennedy B, Ziegler M (1985) "Effects of physostigmine on pulse, blood pressure, and serum epinephrine levels." Am J Psychiatry, 142, p. 738-40
- Dysken MW, Janowsky DS (1985) "Dose-related physostigmine-induced ventricular arrhythmia: case report." J Clin Psychiatry, 46, p. 446-7
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
- (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
- (2001) "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals
Cholinesterase inhibitor (applies to Mestinon Timespan) bronchospasm
Major Potential Hazard, High plausibility. Applicable conditions: Asthma, Chronic Obstructive Pulmonary Disease
Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma or obstructive pulmonary disease. Monitoring respiratory function during dosage initiation and adjustment is recommended. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress. Neostigmine may produce more severe muscarinic side effects than does pyridostigmine and ambenonium. However, the duration of action is longest for ambenonium and shortest for edrophonium. Echothiophate iodide ophthalmic may be systemically absorbed and cautious use is recommended in these patients.
References
- Wilcock GK, Surmon D, Forsyth D, Morgan R (1988) "Cholinergic side-effects of tetrahydroaminoacridine." Lancet, 2, p. 1305
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
- (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
- (2001) "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals
Cholinesterase inhibitor (applies to Mestinon Timespan) coronary artery disease
Major Potential Hazard, High plausibility. Applicable conditions: Ischemic Heart Disease
The use of cholinesterase inhibitors has been associated with a constriction of coronary arteries. Therapy with cholinesterase inhibitors should be administered cautiously in patients with coronary artery disease.
References
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
Cholinesterase inhibitor (applies to Mestinon Timespan) parkinsonism
Major Potential Hazard, High plausibility.
Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.
References
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- el-Yousef MK, Janowsky D, Davis JM, Sekerke HJ (1973) "Reversal of antiparkinsonian drug toxicity by physostigmine: a controlled study." Am J Psychiatry, 130, p. 141-5
- Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
- (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
Cholinesterase inhibitor (applies to Mestinon Timespan) PUD
Major Potential Hazard, High plausibility. Applicable conditions: Peptic Ulcer
The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Therapy with cholinesterase inhibitors should be administered cautiously in patients with peptic ulcer disease.
References
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
- (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
- (2001) "Product Information. Reminyl (galantamine)." Janssen Pharmaceuticals
Cholinesterase inhibitor (applies to Mestinon Timespan) seizures
Major Potential Hazard, High plausibility.
Cholinesterase inhibitors have been associated with convulsions and tremor. Therapy with cholinesterase inhibitors should be administered cautiously in patients with seizure disorders.
References
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- Stewart GO (1979) "Convulsions after physostigmine." Anaesth Intensive Care, 7, p. 283
- "Product Information. Phospholine Iodide (echothiophate iodide ophthalmic)." Wyeth-Ayerst Laboratories
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
- "Product Information. Humorsol Ocumeter (demecarium bromide ophthalmic)." Merck & Co., Inc
- "Product Information. Eserine Sulfate Ophthalmic (PHYSostigmine ophthalmic)." Ciba Vision Ophthalmics
- (2001) "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals
Cholinesterase inhibitor (applies to Mestinon Timespan) hyperthyroidism
Moderate Potential Hazard, High plausibility.
Many of the manifestations of hyperthyroidism may be exacerbated by increased levels of acetylcholine produced by cholinesterase inhibitors. Therapy with cholinesterase inhibitors should be administered cautiously to patients with hyperthyroidism. Monitoring of thyroid levels is recommended.
References
- (2001) "Product Information. Cognex (tacrine)." Parke-Davis
- Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
- "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
- (2001) "Product Information. Aricept (donepezil)." Pfizer U.S. Pharmaceuticals
Mestinon Timespan drug interactions
There are 76 drug interactions with Mestinon Timespan (pyridostigmine).
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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