Pyridostigmine for myasthenia gravis

In Aotearoa New Zealand pyridostigmine is available as tablets (60 mg).

• The dose of pyridostigmine is different for different people, depending on your condition.
• You doctor will usually start you on a lower dose and increase it slowly, depending on your symptoms.
• Pyridostigmine works quickly (within 30 minutes) and the effect lasts for up to 4 hours. You're most likely to have this medicine prescribed to be taken every 3 to 4 hours. It's best taken at times when strength is needed, such as before getting out of bed and before meal times.  
• Always take pyridostigmine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

• Timing of your dose:  You can take pyridostigmine with or without food. Swallow the tablets with a glass of water. If you have problems swallowing the tablets, they may be halved or crushed. Ask your pharmacist for advice. 
  Pyridostigmine works quickly (within 30 minutes) and the effect lasts for up to 4 hours. You're most likely to have this medicine prescribed to be taken every 3 to 4 hours. It's best taken at times when strength is needed, such as before getting out of bed and before meal times.  
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, take the next dose at the right time. Don't take extra doses to make up for a forgotten dose. 

Here are some things to know when you're taking pyridostigmine. Other things may be important as well, so ask your healthcare provider what you should know about.

• Other medicines: Pyridostigmine can interact with some medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting pyridostigmine and before starting any new products.
• Avoid or limit alcohol while you are taking pyridostigmine. Alcohol can increase your chance of side effects, such as flushing and tiredness.
• If you are having an operation or dental treatment, tell your healthcare provider that you are taking pyridostigmine. Pyridostigmine can interfere with some medicines used during surgery.
• Pregnancy: Tell your doctor if you're pregnant, planning to become pregnant, or breastfeeding.

Like all medicines, pyridostigmine can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.