Pyridostigmine

Pyridostigmine
Clinical data
Trade names	Mestinon, others
AHFS/Drugs.com	Monograph
MedlinePlus	a682229
Pregnancy; category	AU: C;
Routes of; administration	By mouth, intravenous
Drug class	Acetylcholinesterase inhibitor; Parasympathomimetic
ATC code	N07AA02 (WHO) ;
Legal status
Legal status	UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Bioavailability	7.6 ± 2.4%
Elimination half-life	1.78 ± 0.24 hours
Excretion	kidney
Identifiers
	IUPAC name 3-[(dimethylcarbamoyl)oxy]-1-methylpyridinium;
CAS Number	155-97-5 ;
PubChem CID	4991;
DrugBank	DB00545 ;
ChemSpider	4817 ;
UNII	19QM69HH21;
KEGG	C07410 ;
ChEMBL	ChEMBL1115 ;
CompTox Dashboard (EPA)	DTXSID20165786 ;
Chemical and physical data
Formula	C9H13N2O2
Molar mass	181.215 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C(Oc1ccc[n+](c1)C)N(C)C;
	InChI InChI=1S/C9H13N2O2/c1-10(2)9(12)13-8-5-4-6-11(3)7-8/h4-7H,1-3H3/q+1 ; Key:RVOLLAQWKVFTGE-UHFFFAOYSA-N ;
	(verify)

Pyridostigmine is a medication used to treat myasthenia gravis and underactive bladder. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. It is also used off-label to treat some forms of Postural orthostatic tachycardia syndrome. It is typically given by mouth but can also be used by injection. The effects generally begin within 45 minutes and last up to 4 hours.

Common side effects include nausea, diarrhea, frequent urination, and abdominal pain. More severe side effects include low blood pressure, weakness, and allergic reactions. It is unclear if use in pregnancy is safe for the fetus. Pyridostigmine is an acetylcholinesterase inhibitor in the cholinergic family of medications. It works by blocking the action of acetylcholinesterase and therefore increases the levels of acetylcholine.

Pyridostigmine was patented in 1945 and came into medical use in 1955. It is on the World Health Organization's List of Essential Medicines. Pyridostigmine is available as a generic medication.