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What is pyridostigmine? Pyridostigmine affects chemicals in the body that are involved in the communication between nerve impulses and muscle movement. Pyridostigmine is used to treat the symptoms of myasthenia gravis. It is also used in military personnel who have been exposed to nerve gas. Pyridostigmine may also be used for purposes not listed in this medication guide. Warnings You should not use pyridostigmine if you you have a bladder or bowel obstruction. Before taking this medicine You should not use pyridostigmine if you are allergic to it, or if you have a bladder or bowel obstruction. To make sure you can safely take pyridostigmine, tell your doctor if you have any of these other conditions: asthma; or kidney disease. FDA pregnancy category C. It is not known whether pyridostigmine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using pyridostigmine. It is not known whether pyridostigmine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. Pyridostigmine is not approved for use by anyone younger than 18 years old. How should I take pyridostigmine? Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Take this medicine with food or milk if it upsets your stomach. Do not crush, chew, or break an extended-release tablet. Swallow it whole. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it. Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted. If you need surgery, tell the surgeon ahead of time that you are using pyridostigmine. You may need to stop using the medicine for a short time. Store at room temperature away from moisture and heat. Keep the tablets in their original container, along with the canister of moisture-absorbing preservative that comes with this medicine. What happens if I miss a dose? 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. Overdose symptoms may include nausea, vomiting, diarrhea, stomach cramps, sweating, blurred vision, drooling, and weak or shallow breathing. Worsening muscle weakness, or no change in your myasthenia gravis symptoms, may also be signs of overdose. What should I avoid while taking pyridostigmine? This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Drinking alcohol can increase certain side effects of pyridostigmine. Pyridostigmine side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using pyridostigmine and call your doctor at once if you have any of these serious side effects: extreme muscle weakness; loss of movement in any part of your body; weak or shallow breathing; slurred speech, vision problems; or worsening or no improvement in your symptoms of myasthenia gravis. Common side effects may include: stomach pain, nausea, vomiting, diarrhea; muscle cramps, twitching; sweating, increased salivation; cough with mucus; rash; or blurred vision. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What other drugs will affect pyridostigmine? Other drugs may interact with pyridostigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.