Mestinon (pyridostigmine) is a cholinesterase inhibitor. It works by preventing the breakdown of a chemical called acetylcholine. Acetylcholine is important for the normal functioning of muscles. Mestinon is used to treat myasthenia gravis. Mestinon may also be used for purposes not listed in this medication guide. You should not use Mestinon if you are allergic to pyridostigmine or neostigmine (Prostigmin). To make sure Mestinon is safe for you, tell your doctor if you have: asthma or other breathing disorder; a history of seizures; kidney disease; liver disease; diabetes; a muscle disorder such as myasthenia gravis or Parkinson's disease; underactive thyroid; ulcerative colitis or Crohn's disease; a history of stomach surgery; a blood disorder such as anemia (lack of red blood cells); or if you are receiving dialysis. FDA pregnancy category C. It is not known whether Mestinon will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Pyridostigmine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Mestinon. Do not give this medication to a child without medical advice. How should I take Mestinon? Take Mestinon exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Mestinon is usually taken every four hours. Follow your doctor's instructions. Do not take more Mestinon than is recommended on the label or prescribed by your doctor. An overdose of pyridostigmine can be fatal. Mestinon is sometimes taken on an as-needed basis, such as 30 minutes before you start physical activity. Your doctor may occasionally change your dose to make sure you get the best results. To take Mestinon orally disintegrating tablets (Mestinon Timespan): Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet. Using dry hands, remove the tablet and place it in your mouth. Allow the tablet to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet. The orally disintegrating tablet can be taken with or without water. Call your doctor if your symptoms do not improve, or if they get worse while using Mestinon. Store at room temperature away from moisture, heat, and light. Keep the orally disintegrating tablets in the blister pack until you are ready to take the medicine. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet. Using dry hands, remove the tablet and place it in your mouth. Allow the tablet to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet. The orally disintegrating tablet can be taken with or without water. Do not take more Mestinon than is recommended on the label or prescribed by your doctor. An overdose of pyridostigmine can be fatal. Mestinon is sometimes taken on an as-needed basis, such as 30 minutes before you start physical activity. Your doctor may occasionally change your dose to make sure you get the best results. To take Mestinon orally disintegrating tablets (Mestinon Timespan): Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet. Using dry hands, remove the tablet and place it in your mouth. Allow the tablet to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet. The orally disintegrating tablet can be taken with or without water. Call your doctor if your symptoms do not improve, or if they get worse while using Mestinon. Store at room temperature away from moisture, heat, and light. What happens if I miss a dose? Since Mestinon is taken as needed, you may not be on a dosing schedule. If you are on a schedule, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of pyridostigmine can be fatal. Overdose symptoms may include severe forms of some of the side effects listed in this medication guide. What should I avoid while taking Mestinon? There are no restrictions on food, beverages, or activity while you are taking Mestinon unless your doctor has told you otherwise. Mestinon side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: seizure (convulsions); a light-headed feeling, like you might pass out; weak or shallow breathing; fast or pounding heartbeats and sudden dizziness (like you might pass out); new or worsening cough with fever, trouble breathing; stomach pain, diarrhea that is watery or bloody; kidney problems --little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; --little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; liver problems --nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or --nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or low blood sugar--headache, hunger, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery.

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