Pyridostigmine Side Effects

Brand Names: Regonol, Mestinon

Please note - some side effects for Pyridostigmine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Pyridostigmine - for the Consumer

Pyridostigmine

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with Pyridostigmine. Seek medical attention right away if any of these SEVERE side effects occur when using Pyridostigmine:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Pyridostigmine Controlled-Release Tablets

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with Pyridostigmine Controlled-Release Tablets. Seek medical attention right away if any of these SEVERE side effects occur when using Pyridostigmine Controlled-Release Tablets:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Pyridostigmine Syrup

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with Pyridostigmine Syrup. Seek medical attention right away if any of these SEVERE side effects occur when using Pyridostigmine Syrup:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Pyridostigmine Tablets

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with Pyridostigmine Tablets. Seek medical attention right away if any of these SEVERE side effects occur when using Pyridostigmine Tablets:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Pyridostigmine Side Effects - for the Professional

Pyridostigmine

The side effects of Pyridostigmine bromide are most commonly related to overdosage and generally are of two varieties, muscarinic and nicotinic. Among those in the former group are nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis, increased salivation, increased bronchial secretions, miosis and diaphoresis. Nicotinic side effects are comprised chiefly of muscle cramps, fasciculation and weakness. Muscarinic side effects can usually be counteracted by atropine, but for reasons shown in the preceding section the expedient is not without danger. As with any compound containing the bromide radical, a skin rash may be seen in an occasional patient. Such reactions usually subside promptly upon discontinuance of the medication.

Side Effects by Body System

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.

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