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Some commonly used brand names are:
In the U.S.—
Antimyasthenics are given by mouth or by injection to treat myasthenia gravis. Neostigmine may also be given by injection as a test for myasthenia gravis. Sometimes neostigmine is given by injection to prevent or treat certain urinary tract or intestinal disorders. In addition, neostigmine or pyridostigmine may be given by injection as an antidote to certain types of muscle relaxants used in surgery.
These medicines are available only with your doctor"s prescription in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the antimyasthenics, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to ambenonium, bromides, neostigmine, or pyridostigmine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Antimyasthenics have not been reported to cause birth defects; however, muscle weakness has occurred temporarily in some newborn babies whose mothers took antimyasthenics during pregnancy.
Breast-feeding—Antimyasthenics have not been reported to cause problems in nursing babies.
Children—Although there is no specific information comparing use of antimyasthenics in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do in adults.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is not much information comparing use of antimyasthenics in the elderly with use in other age groups, these medicines are not expected to cause different side effects or problems in older people than they do in younger adults.
Other medicines—Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking an antimyasthenic, it is especially important that your health care professional knows if you are using any of the following:
Other medical problems—The presence of other medical problems may affect the use of the antimyasthenics. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
Your doctor may want you to take this medicine with food or milk to help lessen the chance of side effects. If you have any questions about how you should be taking this medicine, check with your doctor.
Take this medicine only as directed . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
If you are taking this medicine for myasthenia gravis :
This is to help your doctor decide whether the dose of this medicine should be increased or decreased and how often the medicine should be taken in order for it to be most effective in your condition.
Dosing—The dose of these medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
The number of tablets or teaspoonfuls of syrup that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking these medicines .
Missed dose—If you miss a dose of this medicine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Symptoms of overdose
Blurred vision; clumsiness or unsteadiness; confusion; convulsions (seizures); diarrhea (severe); increase in bronchial secretions or watering of mouth (excessive); increasing muscle weakness (especially in the arms, neck, shoulders, and tongue); muscle cramps or twitching; nausea or vomiting (severe); shortness of breath, troubled breathing, wheezing, or tightness in chest; slow heartbeat; slurred speech; stomach cramps or pain (severe); unusual irritability, nervousness, restlessness, or fear; unusual tiredness or weakness
Also, check with your doctor as soon as possible if any of the following side effects occur:
Redness, swelling, or pain at place of injection (for pyridostigmine injection only); skin rash (does not apply to ambenonium)
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Diarrhea; increased sweating; increased watering of mouth; nausea or vomiting; stomach cramps or pain
Frequent urge to urinate; increase in bronchial secretions; unusually small pupils; unusual watering of eyes
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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