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Articles

How do you convert an oral pyridostigmine or neostigmine dose to a parenteral neostigmine dose?

23 April 2020This updated Medicines Q&A gives suggested dose conversions from oral pyridostigmine or neostigmine to parenteral neostigmine and includes example dose conversion calculations
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Medicine Compliance Aid Stability

MestinonMylan

Mylan
Mestinon
Tablets 60mg
R1 · Red 1Stability data indicates that the drug is not suitable for CAs.
Unsuitable
Hygroscopic, extended release tablets which are supplied with a dessicant.
9 February 2022

Lactation Safety Information

Yes
Neostigmine
Very limited published evidence of safety
Negligible levels anticipated in milk due to the drug’s properties
3 August 2020

New Medicines

Myasthenia gravis and paralytic ileus - oral solution formulation

Information

New formulation
Viatris
Not Known

Development and Regulatory status

Launched
None
None
June 2022
Jun 22Viatris launches pyridostigmine 12mg/ml oral solution in the UK. NHS list price, £90 per 150ml [3,4].
Apr 19MHRA approves pyridostigmine 12mg/ml oral solution for treatment of adults and children with myasthenia gravis and treatment of adults with paralytic ileus. The approval was using the decentralised procedure. The oral solution is considered by the MHRA to be interchangeable with the reference product, Mestinon 60mg tablets [2].

Category

An anticholinesterase. As an antagonist to cholinesterase, the enzyme which normally destroys acetylcholine, the action of pyridostigmine bromide to potentiate naturally occurring acetylcholine and so enhance neuromuscular transmission in voluntary and involuntary muscles. Available as a 12mg/ml sugar-free oral solution, to be used within 28 days of opening. Store below 25°C.
The incidence ranges from 0.3 to 2.8 per 100,000. It is estimated to affect more than 700,000 people worldwide, with prevalence of MG in the UK estimated at about 15 per 100,000 population. Peak incidence is in the third decade for women and the sixth or seventh decade in men [1].
Myasthenia gravis and paralytic ileus - oral solution formulation
Oral

Evidence based evaluations