Pyridostigmine

Pyridostigmine is a medication used to treat myasthenia gravis and underactive bladder. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type.

It is typically given by mouth but can also be used by injection.

Common side effects include nausea, diarrhea, frequent urination, sweating, and abdominal pain. It is on the World Health Organization's List of Essential Medicines. Pyridostigmine is available as a generic medication.

Medical uses

Pyridostigmine is used to treat muscle weakness in people with myasthenia gravis or forms of congenital myasthenic syndrome and to combat the effects of curariform drug toxicity. Pyridostigmine bromide has been FDA approved for military use during combat situations as an agent to be given prior to exposure to the nerve agent Soman in order to increase survival. Used in particular during the first Gulf War, pyridostigmine bromide has been implicated as a causal factor in Gulf War syndrome.

With pyridostigmine classified as a type of parasympathomimetic, it can be used to treat underactive bladder.

Pyridostigmine sometimes is used to treat orthostatic hypotension. It may also be of benefit in chronic axonal polyneuropathy.

It is also being prescribed off-label for postural orthostatic tachycardia syndrome (POTS) as well as complications resulting from Ehlers–Danlos syndrome.

Contraindications

Pyridostigmine bromide is contraindicated in cases of mechanical intestinal or urinary obstruction and should be used with caution in patients with bronchial asthma.

Side effects

Common side effects include: