Common use
Mestinon contains pyridostigmine bromide and is used to treat myasthenia gravis. The medicine inhibits acetylcholinesterase and increases effects of acetylcholine. It improves neuromuscular transmission, increases gastrointestinal motility, increases muscle tone of the bladder, bronchi, and secretion of exocrine glands, causes bradycardia, miosis, spasm of accommodation.

Dosage and direction
To treat intestinal atony and atonic constipation take orally 60 mg every 4 hours, to treat acute myasthenia gravis use 60-180 mg of the medication 2-4 times a day. Te dose may be increased by your doctor. Swallow the pills whole, do not crush, chew or break extended-release tablets. Do not take double dose of this medication. Take your usually dose next day in the same regularly time.

Precautions
Inform your doctor if you have asthma or kidney disease. Your dose may be increased by your doctor. Follow all recommendations of your health care advisor. Inform your doctor about your hypotension, acute myocardial infarction, ulcers in stomach and duodenum, bradycardia, diabetes, stomach surgery, pregnancy.

Contraindications
This medication cannot be used in patients with peritonitis, and a bladder or bowel obstruction. Do not take Mestinon if you have been treated by depolarizing muscle relaxants (suxametone, dekametone), have hypersensitivity to Mestinon, suffer with iritis, asthma, obstructive ileus, a spasm of gastrointestinal tract, spasm of biliary or urinary tract, myotonia, Parkinson's disease, thyrotoxicosis (excess thyroid hormone production), post-operative shock, in pregnant women.

Possible side effect
Allergic reactions to the medication are possible, their symptoms include hives, skin rash, difficulty breathing, facial swelling. More serious adverse reactions are severe nausea, vomiting or diarrhea, extreme muscle weakness, problems with vision, muscle cramps or twitching, drop in blood pressure, excessive salivation, frequent urination, drop in blood pressure, bradycardia, miosis, convulsions, muscle twitching, myasthenia gravis.

Drug interaction
Atropine reduces effects of Mestinon. Mestinon used together with the depolarizing muscle relaxants, barbiturates and morphine derivatives increases their effects. Mestinon is contraindicated for use with ethanol. M-cholinoblockers, ganglioplegic drugs, quinidine, procainamide, local anesthetics, tricyclic antidepressants, antiepileptic drugs, and drugs for Parkinson's disease decrease effects of Mestinon.

Missed dose
If you forgot to take your dose in time, please do it as soon as you remember. But do not take if it is too late or almost time for your next dose.

Overdose
Signs of overdose are nausea, vomiting, extreme muscle weakness, diarrhea, sweating, and muscle cramps, or weakness, involuntary defecation and urination, intestinal colic. Contact your doctor immediately if you experience any of the symptoms listed in this section.

Storage
Store in a dry tight container away from sunlight at room temperature between 15-30 C (59-86 F) away from children and pets.

Disclaimer
We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.