Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Mode of Action
Pyridostigmine bromide facilitates impulse transmission across the myoneural junction by inhibiting the destruction of acetylcholine by acetylcholinesterase. It also has direct cholinomimetic effect on skeletal muscles.
Interaction
May exacerbate night vision problems w/ anti-glaucoma drugs. Antagonises the effect of non-depolarising muscle relaxants (e.g. pancuronium, vecuronium). Prolongs the effect of depolarising muscle relaxants (e.g. suxamethonium).
Pregnancy Category Note
Pregnancy Category: B
Lactation: Compatible
Adult Dose
Oral
Myasthenia gravis
Adult: 30-120 mg in divided doses, up to a total daily dose of 0.3-1.2 g.
Paralytic ileus and postoperative urinary retention
Adult: 60-240 mg daily.
Child Dose
Oral
Myasthenia gravis
Child: <6 yr Initially, 30 mg; 6-12 yr Initially, 60 mg. Doses are repeated throughout the day up to a usual total daily dose of 30-360 mg, w/ increments of 15-30 mg daily until a satisfactory response is obtained.
Paralytic ileus and postoperative urinary retention
Child: 15-60 mg daily.
Renal Dose
Renal impairment: Lower initial dose may be needed, titrate to desired effect.
Administration
Should be taken with food.
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