Pystinon 60 mg
Pyridostigmine bromide 60 mg/tab.
Company Name
AlexandriaTherapeutic Group
ALL OTHER CNS DRUGSPharmaceutical form
Tablet
Package20 Tablets
Indications
Pystinon is useful for the treatment of intestinal atony, atonic constipation and myasthenia gravis pseudoparalytica.Warning & Precautions
Although failure of patients to show clinical improvement may reflect underdosage, it can also be indicative of overdosage. As is true of all cholinergic drugs, overdosage of Pyridostigmine may result in cholinergic crisis, a state characterized by increasing muscle weakness which, through involvement of the muscles of respiration, may lead to death. Myasthenic crisis due to an increase in the severity of the disease is also accompanied by extreme muscle weakness, and thus may be difficult to distinguish from cholinergic crisis on a symptomatic basis. Such differentiation is extremely important, since increases in doses of Pyridostigmine or other drugs of this class in the presence of cholinergic crisis or of a refractory or insensitive state could have grave consequences. Atropine may also be used to abolish or obtund gastrointestinal side effects or other muscarinic reactions, but such use, by masking signs of overdosage, can lead to inadvertent induction of cholinergic crisis .Product Type
HumanDosage
It is important to remember that the full effect appears gradually, usually within 15-30 minutes. Pystinon 60 mg tablets is used as directed by the physician or as follows: In Intestinal atony, atonic constipation:1 tablet as required e.g at intervals of four hours Myasthenia gravis pseudoparalytica: 1-3 tablets two to four times daily, or higher doses if required. In myasthenia gravis one dose is effective for approximately four hours during the day, while at night (owing to reduced physical activity), a longer duration of effect of around six hours can be expected. It is recommended that the times of administration be chosen so that the maximum effect coincides with the most strenous physical exertion e.g when getting up and at meal times Special dosage instructions: When used in pediatrics the required dose must be carefully titrated . In age or disease related impairment of kidney function, longer intervals between doses or lower follow up doses may be appropriate. A suggested dose for children is 7 mg /kg body weight daily in 5 or 6 divided doses. An alternative regimen is an initial dose of 30 mg for children under 6 years or 60 mg for those aged 6 to 12 years. This is increased gradually by increments of 15 to 30 mg daily until a satisfactory response is obtained, which is usually within the dosage range of 30-360 mg daily.Adverse Reactions
The Side effects of Pyridostigmine are most commonly related to overdosage and generally are of two varieties, muscarinic and nicotinic. Among those in the former group are nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis increased salivation, increased bronchial secretions, miosis and diaphoresis. Nicotinic side effects are comprised, chiefly of muscle cramps, fasciculation and weakness. Muscarinic side effects can usually be counteracted by atropine, but for reasons shown in the preceding section the expedient is not without danger. As with any compound containing the bromide radical, a skin rash may be seen in an occasional patient. Such reactions usually subside promptly upon discontinuance of the medicationContra Indications
Pyridostigmine is contraindicated in mechanical intestinal or urinary obstruction, and particular caution should be used in its administration to patients with bronchial asthma Care should be observed in the use of atropine for counteracting side effects
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