Pyridostigmine pour la myasthénie grave
Mestinon
Revu par Sid DajaniDernière mise à jour par Michael Stewart, MRPharmSDernière mise à jour 9 juin 2024
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Doses vary from person to person so it is important that you take pyridostigmine tablets exactly as you are directed by your doctor.
The effect of the tablets lasts for about 4-6 hours. Take your doses at suitable intervals during the day to give you the most strength when needed.
En un coup d'œil
Pyridostigmine is a medicine called an anticholinesterase.
It is used to treat myasthenia gravis, a condition that causes muscle weakness.
It works by increasing the amount of a chemical that helps muscles contract.
Take tablets 30-60 minutes before you need your muscles to be strongest.
Common side-effects include feeling sick, vomiting, diarrhoea, and tummy cramps.
Tell your doctor if you are pregnant, breastfeeding, or have certain health conditions.
Always tell medical staff you are taking pyridostigmine if having an operation or dental work.
About pyridostigmine
Type de médicament | An anticholinesterase |
Utilisé pour | Myasthénie grave |
Aussi appelé | Mestinon® |
Disponible sous forme de | Comprimés |
Myasthénie grave is a condition where your muscles become easily tired and weak. There is a fault in the way nerve messages are passed from your nerves to your muscles. As a consequence, your muscles are not stimulated properly, so do not tighten (contract) well. The muscles around the eyes are commonly affected first. Myasthenia gravis is an autoimmune disease. This means that the fault is due to a problem with your immune system. Your immune system (which normally protects your body from infections) mistakenly attacks itself.
Your brain normally sends messages down nerves to the muscles it wants to contract. The nerve endings then release a chemical called acetylcholine. Acetylcholine quickly attaches to small areas on your muscles, called receptors, and this triggers your muscles to contract. In most people with myasthenia gravis, the immune system blocks or damages these acetylcholine receptors. The acetylcholine cannot then attach to the receptor and so the muscle is less able to tighten.
Pyridostigmine works by slowing the breakdown of acetylcholine when it is released from nerve endings. This means that there is more acetylcholine available to attach to the muscle receptors, and this improves the strength of your muscles. Pyridostigmine is the most commonly prescribed anticholinesterase.
Before taking pyridostigmine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking pyridostigmine it is important that your doctor knows:
Si vous êtes enceinte ou si vous allaitez.
Si vous avez asthme or chronic obstructive pulmonary disease (COPD).
If you have any of the following conditions: epilepsy, la maladie de Parkinson, an overactive thyroid gland or pression artérielle basse.
If you have a heart condition, such as a slow heart rate, or if you have recently had a heart attack.
If you have a ulcère de l'estomac.
Si vous avez des problèmes avec le fonctionnement de vos reins.
If you feel you may have a blockage in your intestines, or if you have any difficulties passing urine.
Si vous prenez ou utilisez d'autres médicaments. Cela inclut tous les médicaments que vous prenez et qui sont disponibles à l'achat sans ordonnance, ainsi que les médicaments à base de plantes et complémentaires.
Si vous avez déjà eu une réaction allergique à un médicament.
How to take pyridostigmine
Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about pyridostigmine and will provide you with a full list of the side-effects which you may experience from taking the tablets.
Take pyridostigmine tablets exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said to you. It is usual for adults to take ½-2 tablets several times a day. The tablets take 30-60 minutes to start working and their effect will last for about 4-6 hours. Take the tablets at suitable intervals so that your muscles are strongest when you need to be the most active (for example, early in the morning and before meals). When pyridostigmine is prescribed for a child, the dose is calculated according to the age of the child.
Swallow the tablet(s) with a drink of water.
If you forget to take a dose at your usual time, take it when you remember. However, if it is just about time to take your next dose when you remember then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Tirer le meilleur parti de votre traitement
Essayez de respecter vos rendez-vous réguliers avec votre médecin. Cela permet à votre médecin de suivre vos progrès.
It is possible that you will be prescribed other medicines to take alongside pyridostigmine. You may be prescribed an immunosuppressant or corticosteroid medicine to help control your muscle symptoms. You may also be prescribed tablets to reduce side-effects if you are troubled by these.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking pyridostigmine. This is important because pyridostigmine can interfere with some medicines used during surgery.
If you buy any medicines, always check with a pharmacist that they are suitable for you to take with your other medicines.
Can pyridostigmine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with pyridostigmine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common pyridostigmine side-effects | Que puis-je faire si je ressens cela ? |
Se sentir malade (nausée) ou être malade (vomissements), diarrhée | Avoid rich or spicy foods, and drink plenty of water. If this becomes troublesome, speak with your doctor who may prescribe you a medicine to help control these symptoms |
Tummy (abdominal) cramps, more saliva produced than usual | If either of these become troublesome, speak with your doctor for further advice |
Si vous ressentez d'autres symptômes que vous pensez être dus aux comprimés, parlez-en à votre médecin ou à votre pharmacien pour obtenir des conseils supplémentaires.
How to store pyridostigmine
Gardez tous les médicaments hors de la portée et de la vue des enfants.
Conserver dans un endroit frais et sec, à l'abri de la chaleur et de la lumière directes.
Informations importantes sur tous les médicaments
Informations importantes sur tous les médicaments
Ne prenez jamais plus que la dose prescrite. Si vous soupçonnez que vous ou quelqu'un d'autre avez pris une surdose de ce médicament, rendez-vous au service des urgences de votre hôpital local. Emportez le contenant avec vous, même s'il est vide.
Ce médicament est pour vous. Ne le donnez jamais à d'autres personnes, même si leur état semble être le même que le vôtre.
Ne gardez pas de médicaments périmés ou indésirables. Apportez-les à votre pharmacie locale qui s'en débarrassera pour vous.
Si vous avez des questions concernant ce médicament, demandez à votre pharmacien.
Signaler les effets secondaires d'un médicament ou d'un vaccin
Si vous ressentez des effets secondaires, vous pouvez les signaler en ligne via le Site web de Yellow Card.

Vous n'êtes pas sûr de mélanger des médicaments ?
Vérifiez les interactions possibles entre les médicaments, les compléments et les aliments avant de les prendre ensemble.
Questions fréquemment posées
What is myasthenia gravis and how does it relate to pyridostigmine?
Myasthenia gravis is an autoimmune condition where your muscles tire and weaken easily due to a fault in how nerve messages are passed to your muscles. This happens because your immune system mistakenly attacks and blocks or damages the acetylcholine receptors on your muscles. Pyridostigmine helps by slowing the breakdown of acetylcholine, making more of it available to stimulate muscle contraction and improve muscle strength.
What should I do if I forget to take a dose of pyridostigmine?
If you forget a dose, take it as soon as you remember. However, if it's nearly time for your next scheduled dose, skip the forgotten dose and continue with your regular dosing schedule. It's important not to take a double dose to compensate for a missed one.
Are there any specific foods or drinks I should avoid while taking pyridostigmine?
The article suggests that if you experience feeling sick, vomiting, or diarrhoea, you should avoid rich or spicy foods and drink plenty of water. There are no other specific food restrictions mentioned.
What should I do if I experience persistent or troublesome side-effects?
While some side-effects improve as your body adjusts to the medicine, if any common side-effects like nausea, vomiting, diarrhoea, tummy cramps, or excessive saliva production continue or become problematic, you should speak with your doctor or pharmacist for advice.
Can I take other medicines alongside pyridostigmine?
You may be prescribed other medicines, such as immunosuppressants or corticosteroids, to help control your muscle symptoms from myasthenia gravis. Your doctor might also give you medicines to reduce side-effects. It is crucial to inform your doctor about all other medicines you are taking, including over-the-counter, herbal, and complementary medicines, as pyridostigmine can interfere with some drugs, particularly those used during surgery. Always check with a pharmacist if buying new medicines to ensure they are suitable to take with pyridostigmine.
How should I dispose of old or unwanted pyridostigmine?
Do not keep out-of-date or unwanted medicines. You should take them to your local pharmacy for proper disposal.
Lectures complémentaires et références
- Manufacturer's PIL, Mestinon® 60 mg Tablets; Mylan (Viatris), The electronic Medicines Compendium. Dated July 2023.
- Médicaments Complets BNF 89e Édition; Association Médicale Britannique et Société Royale Pharmaceutique de Grande-Bretagne, Londres.
À propos de l'auteurVoir la biographie complète

Michael Stewart, MRPharmS
Responsable de l'examen des notices de médicaments – Contractuel, Pharmacien
BPharm (Hons), MRPharmS
Michael est un pharmacien communautaire exerçant dans les Midlands et le South Yorkshire avec plus de 20 ans d'expérience dans le conseil sur les médicaments et les conditions médicales. Il possède une solide expérience en formation dans le domaine de la santé, ayant produit et dispensé des cours de formation pour les équipes de pharmacie et le personnel des établissements de soins résidentiels, y compris les infirmières. Il a également contribué aux comités consultatifs de pharmacie pour la gestion des affections de faible gravité dans la communauté.
À propos du critique

Sid Dajani
Sultan Dajani a obtenu son diplôme à la London School of Pharmacy en 1994 et est devenu le plus jeune membre élu du conseil de la Royal Pharmaceutical Society depuis sa fondation en 1842.
Historique de l'article
Les informations sur cette page sont rédigées et examinées par des cliniciens qualifiés.
Article également disponible en Anglais, Allemand, Espagnol, Français, Italien, Portugais, Hindi, Hébreu, Arabe, and Suédois.
Next review due: 22 May 2027
9 juin 2024 | Dernière version

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