What is Pyridostigmine ER: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Pyridostigmine ER overview

BRAND NAMES:

  • Mestinon, Mestinon Timespan, Pyridostigmine Bromide AvPak

Generic Names:

  • Pyridostigmine Bromide Er

Uses:

  • Treats myasthenia gravis (a muscle disease).

Therapeutic Classes:

  • Central Nervous System Agent, Immunological Agent, Nerve Gas Antidote

Forms:

  • Tablet, Long Acting Tablet, Liquid

How it’s taken:

  • By mouth

What is Pyridostigmine ER used for?

What form(s) does Pyridostigmine ER come in

  • Tablet

  • Long Acting Tablet

  • Liquid

What are common Pyridostigmine ER doses?

  • Tablet 180mg

Common Pyridostigmine ER prescriptions

  • pyRIDostigmine Bromide ER
    180mg tablet

How to take Pyridostigmine ER

  • Your doctor will tell you how much to take and how often.

  • You may take this medicine with food or milk to avoid stomach upset.

  • Swallow the extended-release tablet whole. Do not crush or chew before swallowing.

  • Measure the oral liquid with a marked measuring spoon or medicine cup.

  • You may take this medicine with food or milk to avoid stomach upset.

  • Swallow the extended-release tablet whole. Do not crush or chew before swallowing.

  • Your doctor will tell you how much to take and how often.

  • Measure the oral liquid with a marked measuring spoon or medicine cup.

What to do if you miss a dose of Pyridostigmine ER

  • You should not use two doses at the same time.

  • Take the missed dose as soon as possible.

  • Skip the missed dose if it is almost time for your next regular dose.

Pyridostigmine ER contraindications

  • You should not use this medicine if you have ever had an allergic reaction to pyridostigmine.

Pyridostigmine ER warnings

  • Talk with your doctor if you are pregnant, breastfeeding, or have asthma, heart disease, an enlarged prostate, or intestinal or urinary blockage. Tell your doctor if you become pregnant while taking this medicine.

  • This medicine may cause confusion or blurred vision. Be careful when driving a car or using machinery.

  • Trouble breathing

  • Slurred speech

  • Confusion

  • Irregular heartbeat

Pyridostigmine ER interactions

  • Avoid drinking alcohol while you are taking this medicine.

  • Avoid taking other medicines that make you sleepy such as sleeping pills, cold or allergy medicine, strong pain killers, or tranquilizers (Thorazine®, Mellaril®).

Pyridostigmine ER side effects

Serious Side Effects

  • Skin rash, itching, or hives

  • Seizures

  • Trouble breathing

  • Slurred speech

  • Confusion

  • Irregular heartbeat

  • Watering eyes

Less Serious Side Effects

  • Anxiety

  • Nausea, vomiting, or diarrhea

  • Increased saliva

  • Muscle cramps or twitching

  • Stomach cramps

  • Nervousness

  • Watering eyes

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