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Mestinon 60 mg Tablets
Pyridostigmine bromide
Please read all of this leaflet carefully before you
start taking this medicine.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your
doctor or pharmacist.
• This medicine has been prescribed for you.
Do not pass it on to others. It may harm them,
even if their symptoms are the same as yours.
• If you experience any side effect and this
becomes serious, tell your doctor or pharmacist.
In this leaflet:
1. What Mestinon is and what it is used for
2. Before you take Mestinon Tablets
3. How to take Mestinon Tablets
4. Possible side effects
5. How to store Mestinon Tablets
6. Further information
Mestinon is used for the treatment of myasthenia
gravis. In patients who suffer from myasthenia gravis
the muscles quickly become tired and weak and,
in severe cases, the muscles may become paralysed.
Myasthenia gravis is caused by excessive activity
in the body of a protein called cholinesterase.
Mestinon belongs to a group of medicines known as
cholinesterase inhibitors. Cholinesterase inhibitors
stop the excessive activity of cholinesterase and in
this way help muscles to work properly.
Mestinon is also used to treat some rare forms of
constipation (paralytic ileus) and inability to pass
urine after an operation.
Do not take Mestinon Tablets if you:
• Are allergic (hypersensitive) to pyridostigmine,
bromides or any of the other ingredients of Mestinon
Tablets (these are listed in section 6, ˝Further
• Are constipated or cannot urinate, unless your
doctor has told you to use this medicine. This is
because Mestinon is only for some types of constipation and inability to pass urine (see Section 1).
Take special care with Mestinon
Before treatment with Mestinon, tell your doctor
if you:
• Suffer from asthma or have other chest problems
such as wheeziness, difficulty in breathing or chronic
• Have recently had coronary obstruction (heart
attack), have a slow heart beat or any other heart
• Have low blood pressure.
• Have a stomach ulcer.
• Have epilepsy.
• Have Parkinson’s disease.
• Have kidney problems.

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• S uffer from a condition called
vagotonia (this is a condition
where overactivity of the
vagus nerve causes symptoms
such as slow heart rate, low
blood pressure, constipation,
sweating and painful muscle
• Have an overactive thyroid
• Have had an operation to remove your thymus
There is no evidence to suggest that Mestinon has any
special effects on elderly patients.
Taking other medicines
Please tell your doctor or pharmacist if you are taking
or have recently taken any other medicines, including
medicines obtained without a prescription.
This is extremely important, as using more than
one medicine at the same time can strengthen or
weaken the effect of the medicines. In particular, tell
your doctor if you are taking any of the following
• Medicines known as steroids or other
immunosuppressant medicines.
• Medicines known as antimuscarinics
(e.g. atropine, hyoscine).
• Medicines containing methylcellulose
• Antibiotics
• Medicines to treat an irregular heart beat
• O ther medicines that interfere with transmission
between nerves and muscles
If you are going to have surgery
Tell your doctor that you are taking Mestinon.
Mestinon can stop the effect of some medicines used
to relax muscles during surgery (e.g. pancuronium,
Mestinon can also prolong the effect of other muscle
relaxants (e.g. suxamethonium).
Pregnancy and breast-feeding
Tell your doctor before you start treatment if you:
• Are pregnant, if you think you are pregnant,
or if you intend to become pregnant.
• Are breast-feeding, as Mestinon passes into breast
milk in small amounts.
Your doctor will then decide if you can take this
Driving and using machines
Mestinon may reduce the sharpness of your eyesight
and therefore your ability to drive or use machines.
Do not drive or operate machines if this medicine
affects your ability to see clearly.
Important information about some of the
ingredients of Mestinon Tablets
Mestinon Tablets contain lactose. Therefore, if you
have been told by your doctor that you have an
intolerance to some sugars, contact your doctor
before taking this medicinal product.

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Swallow the tablets with water or another nonalcoholic drink. If you have difficulty swallowing, you
can break the tablets into pieces.
You should check with your doctor or pharmacist
if you are not sure how to take Mestinon.
The dose will depend on your illness, your needs and
on your age as follows:
For myasthenia gravis:
• The usual adult dose is 1/2 to 2 tablets (30 to 120 mg
Mestinon) to be taken five to six times daily, or
higher doses if needed, as recommended by your
• For children under 6 years, the usual dose is 1/2 a
tablet (30 mg). For children aged 6 to 12 years, the
usual starting dose is 1 tablet (60 mg). The doctor
will then gradually increase the dose until maximum
improvement is seen. In children the total dose per
day is usually 30 to 360 mg.
The tablets take 30 to 60 minutes to start working
after you have taken them.
The effect of each dose should last about four hours
during the day and about six hours at night.
You should try to take your medicine so that it
can work when your muscles are needed most, for
example, when you get up and about 30 to 60 minutes
before a meal.
For paralytic ileus (constipation) and
post-operative inability to pass urine:
• The usual adult dose is 1 to 4 tablets (60 to 240 mg
Mestinon) daily and for children 1/4 to 1 tablet
(15 to 60 mg) daily, depending on the needs of the
If you take more Mestinon than you should
If you take too many tablets or someone else
accidentally takes your medicine, contact your
doctor, pharmacist or nearest hospital straight away.
If you forget to take Mestinon
If you forget to take one of your daily doses, take it
as soon as you remember, and take the next dose at
the normal time. Do not take a double dose to make
up for a forgotten dose. If you miss more than a single
dose, you should contact your doctor for advice.
Like all medicines, Mestinon can cause side effects,
although not everybody gets them.
Possible side effects with Mestinon:
Side effects of unknown frequency:
• visual disturbance, producing more tears than usual
an irregular heart beat, heart block, low blood
pressure, fainting
• producing more phlegm than usual combined with
constriction of the airways
• feeling sick, vomiting, diarrhoea, stomach cramps,
producing more saliva than usual
• rash
• excessive sweating
• muscle weakness and twitching, shaking, muscle
• sudden, compelling urge to urinate.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side

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effects not listed in this leaflet.
You can also report side
effects directly via the
Yellow Card Scheme at:
By reporting side effects you
can help provide more information on the safety of this
Keep Mestinon Tablets out
of the reach and sight of
Store the bottle in the
original outer carton.
Keep the bottle tightly closed in order to protect
from moisture.
Do not store above 25 °C.
Do not use Mestinon Tablets after the expiry date
which is stated on the bottle label and outer carton
after the text ˝EXP˝. The expiry date refers to the
last day of that month.
Medicines must not be disposed of via wastewater
or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These
measures will help to protect the environment.
What Mestinon contains
Active substance:
Each tablet contains 60 mg
of pyridostigmine bromide.
Other ingredients:
Colloidal hydrated silica, maize
starch, lactose monohydrate,
talc and magnesium stearate.
What Mestinon looks like and contents
of the pack
The tablets are scored on one side so that they can
be broken into halves or quarters and ˝ Mes
˝ is
imprinted on the other side.
The tablets come in packs of 200.
A desiccant is enclosed in the bottle.
Marketing Authorisation Holder
Meda Pharmaceuticals Ltd., Skyway House,
Parsonage Road, Takeley, Bishop’s Stortford,
CM22 6PU, UK.
Labiana Pharmaceuticals S.L.U., Casanova 27-31,
08757-Corbera de Llobregat (Barcelona), Spain.
For any information about this medicine, please
contact the Marketing Authorisation Holder or
local distributor.
This leaflet was last revised in
June 2014.


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Further information

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