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Mestinon (pyridostigmine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat myasthenia gravis in adults.
These insights are based on 2,842 comments about Mestinon from MGteam members. These are the experiences of a small number of people and are not meant to be medical advice.
Mestinon works by slowing the breakdown of acetylcholine, a chemical that helps nerves send signals to muscles. This helps signals pass more easily between nerves and muscles. By improving these signals, Mestinon may help increase muscle strength and control symptoms of myasthenia gravis.
Doctors prescribe Mestinon when someone has myasthenia gravis. The medication comes as a liquid (solution), regular tablets, and extended-release tablets that you take by mouth. The dose is adjusted for each person. It is usually taken several times a day. The extended-release tablets may be taken once or twice a day, with at least six hours between doses.
These insights are based on 2,842 comments about Mestinon from MGteam members.Members who use Mestinon often say that timing, side effects, and close communication with a neurologist can make a big difference in day-to-day life. Many also describe using practical tools, like symptom tracking, prisms for double vision, and routines around meals, to help manage treatment more smoothly.
Talk to your doctor if Mestinon seems to wear off.
“I’ve seen my neurologist and we have decided to change my dose of pyridostigmine from 120 milligrams three times a day to 90 milligrams four times a day to see if it gives me better coverage and eases the leg and feet cramps. So far it works great.”
Ask your doctor about ways to ease gastrointestinal side effects.
“I found that taking a probiotic with it has almost completely stopped the diarrhea.”
Consider eye support tools if vision symptoms continue.
“I went to my eye doctor and he fitted me with prisms. He gave me a stick-on one to put on my glasses. I wore that for a month-and-a-half and it did great, so then he made me new glasses with the prisms in them.”
Connect with others who understand life with myasthenia gravis. Join MGteam for free.
In clinical studies, the most common side effects of Mestinon for myasthenia gravis were often linked to overdose (taking too much of the medicine). These side effects fall into two groups: muscarinic effects and nicotinic effects.
Muscarinic effects may include:
Nicotinic effects may include:
A skin rash can also happen in some people.
Mestinon can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Bausch Health, the manufacturer of Mestinon, offers the Bausch Health Patient Assistance Program. Eligible people may receive their medication free of charge, with no copays or shipping costs.
The Bausch Health Patient Assistance Program also offers support to check eligibility, confirm medication coverage, explain program requirements, help complete and track your application, and assist with reapplying if eligible. To learn more, visit the Bausch Health Patient Assistance Program or call 833-862-8727.
Tell your doctor if you have any allergies to pyridostigmine or any ingredients in Mestinon.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Do not take Mestinon if you have a blockage in your intestines or urinary system.
Tell your doctor if you have asthma or kidney problems. You may need closer monitoring or a lower dose. Taking too much Mestinon can cause serious muscle weakness and breathing problems. Get medical help right away if this happens.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Mestinon, talk with your doctor about the risks and benefits.
These answers are fact-checked by our editorial staff.
How effective is Mestinon?
Mestinon is used to treat myasthenia gravis. The dose is different for each person and is adjusted to help control symptoms. Some people may need one to six doses a day, depending on the dosage form, while others may need more depending on how severe their condition is.
How long does Mestinon take to work for myasthenia gravis?
The exact time is not given. The long-acting 180 milligram tablet works about the same at first as a 60 milligram regular tablet, but it lasts about 2.5 times longer. How long it works can vary from person to person.
What side effects can Mestinon cause in myasthenia gravis?
Side effects are often linked to taking too much medicine. Muscarinic side effects include nausea, vomiting, diarrhea, stomach cramps, more saliva, more mucus, small pupils, and sweating. Nicotinic side effects include muscle cramps, twitching, and weakness. A skin rash can also happen.
How often is Mestinon taken for myasthenia gravis?
How often Mestinon is taken depends on the person and the form used. Regular tablets or liquid are usually taken several times a day. Some people may take one to six doses a day, while others may need up to 25 doses. The long-acting tablets are usually taken once or twice a day, with at least six hours between doses.
On MGteam, people share their experiences with myasthenia gravis, get advice, and find support from others who understand.
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