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Pyridostigmine Pregnancy and Breastfeeding Warnings

Pyridostigmine is also known as: Mestinon, Mestinon Timespan, Regonol

Medically reviewed on Nov 20, 2017

Pyridostigmine Pregnancy Warnings

Pyridostigmine has been assigned to pregnancy category C by the FDA. There are no controlled data in human pregnancy. At normal doses, pyridostigmine is not expected to significantly cross the placenta. One case of microcephaly has been reported; however, causality was unclear (disease or drug etiology). Pyridostigmine in large doses reportedly crosses the placenta and reduces fetal plasma cholinesterase activity. Parenteral anticholinesterases have been associated with premature labor when administered near term. Pyridostigmine is only recommended for use during pregnancy when benefit outweighs risk.

See references

Pyridostigmine Breastfeeding Warnings

Pyridostigmine is excreted into human milk. Conclusions from limited data (2 patients) have estimated that infants would ingest less than 0.1% of the maternal dose. Adverse effects in the infant are unlikely. Pyridostigmine is considered compatible with breast-feeding by the American Academy of Pediatrics.

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References for pregnancy information

  1. Al-Shekhlee A, Robin N, Kaminski HJ "Pyridostigmine-induced microcephaly." Neurology 56 (2001): 1606-7
  2. Niesen CE, Shah NS "Pyridostigmine-induced microcephaly." Neurology 54 (2000): 1873-4
  3. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):

References for breastfeeding information

  1. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
  2. Aquilonius S-M, Hartvig P "Clinical pharmacokinetics of cholinesterase inhibitors." Clin Pharmacokinet 11 (1986): 236-49

Further information

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

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