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Pyridostigmine Disease Interactions

There are 7 disease interactions with pyridostigmine.

Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Major

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Moderate

Cholinesterase inhibitor (applies to pyridostigmine) 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.

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Pyridostigmine drug interactions

There are 77 drug interactions with pyridostigmine.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.