How does it work?

Pyridostigmine bromide belongs to the group of medicines called anticholinesterases. It works by prolonging the action acetylcholine, which is found naturally in the body. It does this by inhibiting the action of the enzyme acetylcholinesterase. Acetylcholine stimulates a type of receptor called muscarinic receptors. When stimulated, these receptors have a range of effects.Muscarinic receptors are found throughout the body, especially on muscle. Stimulation of these receptors causes to muscle contraction. In myasthenia gravis the body's immune system destroys many of the muscarinic receptors, so that the muscle becomes less responsive to nervous stimulation. Pyridostigmine bromide increases the amount of acetylcholine at the nerve endings. Increased levels of acetyl choline allow the remaining receptors to function more efficiently. This medicine usually restores mucle function to near-normal levels.

What is it used for?

• Abnormal muscle weakness (myasthenia gravis)
• Difficulty in passing urine (urinary retention)
• Failure of function of part of the gut causing an obstruction (paralytic ileus)

Use with caution in

• Asthma
• Decreased kidney function
• Epilepsy
• Low blood pressure (hypotension)
• Parkinson's disease
• People who have recently had a heart attack
• Peptic ulcer
• Slow heart rate of less than 50 beats per minute (bradycardia)

Not to be used in

• Blockage of the gut (intestinal obstruction)
• Obstruction of the urinary tract (urethra)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
• This medicine should be used with caution by breastfeeding mothers, and only if the expected benefit to the mother is greater than any possible risk to the baby. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Abdominal cramps
• Diarrhoea
• Nausea and vomiting
• Increased salivation

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

Neostigmine bromide should not be used with muscle relaxants such as suxamethonium as this may result in breathing difficulties.

Other medicines containing the same active ingredients