Pyridostigmine

Mestinon · ATC code N07AA02

Also known as: Pyridostigmin, Piridostigmin, Pyridostigmine Bromide · Brand names: Mestinon, Amindan, Kalymin, Pyridostigmin Al, Pyridostigmin Stada, Miyastu, Pryidostigmine Bromide, Regonol

Key facts
Active substance: Pyridostigmine
Drug class: Cholinesterase inhibitor
ATC code: N07AA02
Authorisation: authorised nationally; no central EU authorisation
Information as of: 2026-10-29

Key facts

Pyridostigmine (as pyridostigmine bromide) is a cholinesterase inhibitor. Per the US prescribing information, it is used in the treatment of myasthenia gravis.

What it is used for

Treatment of myasthenia gravis

Dosing

Size and frequency of doses must be adjusted to the needs of the individual patient
Per the label, the average dose is ten 60 mg tablets daily, spaced to give maximum relief when maximum strength is needed
In severe cases as many as 25 tablets a day, in mild cases two to twelve tablets a day; for tablet strengths see the full prescribing information
Renal disease: mainly excreted unchanged by the kidney, so lower doses titrated to effect may be needed
Safety and effectiveness in pediatric patients not established

Contraindications

Mechanical intestinal or urinary obstruction
Particular caution in bronchial asthma
Care in using atropine to counteract side effects

Important warnings

Overdosage may cause cholinergic crisis with increasing muscle weakness that can involve respiratory muscles and lead to death
Myasthenic crisis (worsening disease) is hard to distinguish from cholinergic crisis on symptoms; treatment differs radically
Lack of improvement may reflect underdosage but can also indicate overdosage
In cholinergic crisis, prompt withdrawal of all drugs of this type and immediate use of atropine are recommended

Side effects

Mostly related to overdosage
Muscarinic: nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis, increased salivation, increased bronchial secretions, miosis, diaphoresis
Nicotinic: muscle cramps, fasciculation and weakness
Occasional skin rash from the bromide, usually subsiding promptly after discontinuation

Interactions

Atropine: can counteract muscarinic side effects but is not without danger, as it may obscure overdosage

Pregnancy and breastfeeding

Safety in pregnancy or lactation not established; weigh potential benefits against possible hazards to mother and child

Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.

Full official text →

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For patients

Patient information (US)

This product has no separate US patient information.

Authorisation and brand names by country

Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.

Austria

MestinonViatris Austria Gmbh · 1 register entry

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Germany

AmindanDesitin Arzneimittel Gmbh · 1 register entry
KalyminHormosan Pharma Gmbh · 3 register entries
MestinonViatris Healthcare Gmbh · 3 register entries
Pyridostigmin AlAliud Pharma Gmbh · 1 register entry
Pyridostigmin StadaStadapharm Gmbh · 1 register entry

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Turkey

MestinonVİATRİS İLAÇLARI LİMİTED ŞİRKETİ · 1 register entry
MiyastuKOÇSEL İLAÇ SAN. VE TİC. A.Ş. · 1 register entry

Source: TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, as of 2026-10-16

USA

MestinonBausch Health US, LLC · 1 register entry
Pryidostigmine BromideRising Pharma Holdings, Inc., Apnar Pharma LP · 2 register entries
RegonolSandoz Inc · 1 register entry

Source: U.S. FDA – Drug labels (openFDA/DailyMed), as of 2026-10-29

Brand names in 24 more European countries

Belgium: Mestinon
Bulgaria: Калимин
Croatia: Mestinon
Czechia: Mestinon
Denmark: Mestinon, Pyridostigminbromid Orifarm
Estonia: Kalymin, Mestinon
Finland: Mestinon
France: Mestinon, Pyridostigmine Pharmacie Centrale Des Armees
Greece: Mestinon
Hungary: Mestinon
Ireland: Mestinon
Italy: Mestinon
Latvia: Kalymin, Mestinon
Luxembourg: Mestinon
Malta: Mestinon
Netherlands: Mestinon
Norway: Mestinon
Poland: Mestinon, Stygmistanon
Portugal: Mestinon
Romania: Mestinon
Slovakia: Mestinon
Slovenia: Mestinon
Spain: Mestinon
Sweden: Mestinon, Pyridostigmin Orifarm

EMA – Article 57 product data (EU/EEA), 2026-10-29

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Another question about this substance?

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Sources

U.S. Food and Drug Administration. Pyridostigmine Bromide (Method Pharmaceuticals, LLC) – Prescribing Information, 2026-02-12. DailyMed (NLM), 2026-10-29. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=1aa7a886-c726-cc91-e063-6294a90a1af1
EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, 2026-10-16. https://www.titck.gov.tr/dinamikmodul/85
U.S. FDA – Drug labels (openFDA/DailyMed), 2026-10-29. https://dailymed.nlm.nih.gov/dailymed/
Wikidata (CC0): ATC N07AA.

Editorial: Medelix editorial team · last updated 2026-10-29 · How these pages are made · Report an error

Source: U.S. Food and Drug Administration (FDA), prescribing information, via DailyMed (NLM); public domain. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.