Pyridostigmine Side Effects

Some side effects of pyridostigmine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to pyridostigmine: oral syrup, oral tablet, oral tablet extended release

Get emergency medical help if you have any of these signs of an allergic reaction while taking pyridostigmine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using pyridostigmine and call your doctor at once if you have any of these serious side effects:

• extreme muscle weakness, muscle twicthing;

• slurred speech, vision problems;

• severe vomiting or diarrhea;

• cough with mucus;

• confusion, anxiety, panic attacks;

• seizure (convulsions); or

• worsening or no improvement in your symptoms of myasthenia gravis.

Less serious side effects of pyridostigmine may include:

• cold sweat, pale skin;

• urinating more than usual;

• watery eyes;

• mild nausea, vomiting, or upset stomach;

• warmth or tingly feeling; or

• mild rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to pyridostigmine: injectable solution, oral syrup, oral tablet, oral tablet extended release

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, diarrhea, loose stools, flatulence, abdominal cramps, increased peristalsis, and increased salivation.

Respiratory

Respiratory side effects have included exacerbation of bronchitis and asthma. Adverse effects that are generally associated with overdosage have included increased bronchial secretions and bronchospasm.

Musculoskeletal

Musculoskeletal side effects have included muscle weakness and twitching. Adverse effects that are generally associated with overdosage have included muscle cramps, fasciculation, weakness, and paralysis. Arthralgia, hyperalgesia and joint pain have been reported.

A 46-year-old woman with myasthenia gravis developed arthralgia, hyperalgesia, and joint stiffness after 8 years of pyridostigmine 60 mg orally 5 times daily. The side effects slightly lessened after lowering dose to 60 mg twice a day. Symptoms disappeared upon discontinuation and returned upon rechallenge.

Endocrine

Endocrine side effects have included diaphoresis and rhinorrhea.

Ocular

Ocular side effects are generally associated with overdosage and have included miosis, lacrimation, and blurred vision.

Dermatologic

Dermatologic side effects have included acneiform skin rashes due to the bromide radical, urticaria, toxic alopecia, and alopecia areata.

Hematologic

Hematologic side effects have included thrombophlebitis after intravenous administration. Individual cases of epistaxis and profuse bleeding after a cut have been reported with oral administration.

Cardiovascular

Cardiovascular side effects have included elevations in blood pressure. Adverse effects that are generally associated with overdosage have included bradycardia, tachycardia, cardiospasm, and hypotension.

Nervous system

Nervous system side effects have included headache, vertigo, and tingling of the extremities. Adverse effects that are generally associated with pyridostigmine overdosage and/or bromide intoxication have included agitation, coma, confusion, combativeness, delusions, hallucinations, incoordination, irritability, loss of memory, restlessness, and stupor.

Genitourinary

Genitourinary effects have included urinary urgency and frequency.

Metabolic

Metabolic side effects have been attributed to bromide intoxication and have included a negative anion gap and hyperchloremia.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.