Note: This document contains side effect information about pyridostigmine. Some dosage forms listed on this page may not apply to the brand name Mestinon.
Applies to pyridostigmine: oral conventional 30-mg tablets for military use, oral conventional 60-mg tablets and extended-release tablets, oral oral solution, parenteral injection.
Warning
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Military Use for Soman Poisoning Prophylaxis
- Use of pyridostigmine alone is not protective against soman effects.111 Efficacy depends on rapid use of nerve agent antidotes (i.e., atropine and pralidoxime) following nerve agent exposure.111
- Protective garments (e.g., masks, hoods, overgarments) specifically designed for protection from chemical nerve agents are the primary means of protection against nerve agent exposure; do not rely solely on pretreatment with pyridostigmine, atropine, and pralidoxime to provide complete protection.111
- Do not administer pyridostigmine after soman exposure.111 Discontinue at first sign of nerve agent poisoning; may exacerbate effects of a sublethal exposure.111
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Experience of Health Care Personnel
- Pyridostigmine should be administered by IV injection only by adequately trained individuals familiar with the drug’s actions, characteristics, and risks.124
Side effects include:
Diarrhea, abdominal pain or cramps, dysmenorrhea, increased flatus, nausea, urinary urgency and frequency.
For Healthcare Professionals
Applies to pyridostigmine: injectable solution, oral syrup, oral tablet, oral tablet extended release.
Gastrointestinal
Frequency not reported: Nausea, vomiting, diarrhea, abdominal cramps, GI hypermotility, salivary hypersecretion[Ref]
Respiratory
Frequency not reported: Increased bronchial secretion combined with bronchoconstriction[Ref]
Musculoskeletal
Frequency not reported: Muscle weakness, fasciculation, tremors, muscle cramps, muscle hypotonia[Ref]
Ocular
Frequency not reported: Miosis, increased lacrimation, accommodation disorders[Ref]
Dermatologic
Frequency not reported: Rash, hyperhidrosis[Ref]
Cardiovascular
Frequency not reported: Arrhythmia (including bradycardia, tachycardia, AV block), syncope, hypotension[Ref]
Genitourinary
Frequency not reported: Urinary urgency[Ref]
