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Real members of MGteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Taking the Pyridostigmine Extended Release 180 mg at night or in the morning?

A MGteam Member asked a question 💭
Grantville, KS

My doctor advised I take the Pyridostigmine extended release 180mg at night. I was up the entire night with pretty severe bladder spasms. It certainly gave me more stamina and muscle strength the next morning and through most of the afternoon, but I did not get much sleep the night before because of the severe bladder urgency throughout the entire night. If you have been prescribed the extended release form, have any of you taken it in the morning? I wonder that if I did I might tolerate the… read more

November 1, 2025
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A MGteam Member

Thank you Randy! May I ask, what are some of your symptoms that you have? When I go for my routine 4 month check up, at times I feel as though my doctor questions my symptoms every single time. Instead of moving forward, sometimes I feel he is questioning me.

November 1, 2025
A MGteam Member

I take the extended release in the morning. You might want to try using it in the morning & see what works best for you. I have bladder urgency as well.

November 1, 2025
MGteam

Should you take pyridostigmine extended release 180mg at night or in the morning?

It sounds like you're experiencing a tough side effect that's disrupting your sleep. Bladder urgency can be a known side effect of pyridostigmine, and your instinct about timing makes sense.

Switching to a morning dose could help you Show Full Answer

Should you take pyridostigmine extended release 180mg at night or in the morning?

It sounds like you're experiencing a tough side effect that's disrupting your sleep. Bladder urgency can be a known side effect of pyridostigmine, and your instinct about timing makes sense.

Switching to a morning dose could help you tolerate the bladder symptoms better since you'd be awake and able to manage them more easily. You'd still benefit from the muscle strength throughout the day when you need it most.

However, this is definitely something you should discuss with your doctor before making the change. They can help you determine the best timing based on:

* When your symptoms are typically strongest
* How the medication's peak effectiveness aligns with your daily activities
* Whether the bladder side effects might decrease over time as your body adjusts

Many people with MG find their muscle weakness worsens as the day goes on, so timing medications when you need strength most is important. Your doctor may also have suggestions for managing the bladder symptoms if you continue the nighttime dose.

Don't hesitate to reach out to your healthcare team about this—finding the right medication schedule is part of managing MG effectively.

November 1, 2025
A MGteam Member

Hi MaryGorden 👋🏾
Taking mestinon at night for me was all muscle cramps up and down my feet and legs.
Perhaps if you could ask your doctor for a referral to a urologist. He/she may not be the expert you need. Sometimes we go from one Dr to another but they all become part of our team. Each one staying in their lane of expertise.
I have 4 specialist and they coordinate through Mychart. It's very helpful. I can ask questions and if they don't answer right away I know at least the ? is in there. They get all your information in one place.
It's also an app that you can use to see test results, make appointments contact information for all your hospitals doctors everything.
I hope I was helpful 😎

November 3, 2025
A MGteam Member

Eye droop, problems with my voice, shortness of breath, swallowing issues. Muscle weakness in shoulders & hips.

November 2, 2025

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