Side Effects From Pyridostigmine(Mestinon)
Have you experienced any side effects from the MG treatment Pyridostigmine, commonly called Mestinon? This article on our website, https://myasthenia-gravis.com/treatment/ache-inhibitor, discusses the side effects of these kinds of medications, acetylcholinesterase inhibitors.
Common side effects include:
Stomach cramps
Diarrhea
Muscle twitching and cramps
Sweating
Too much saliva
Have you experienced any of these while using pyridostigmine or other side effects?
- Jodi, Team Member
I have all the side effects on 60 mg three times daily. The excess saliva is not too bad except when I drool. It is much better than waking up to the inside of your mouth all stuck together from dry mouth. The muscle spasms and cramps are slightly worse than what I have anyway from CKD, but mostly tolerable. The GI side effects can be trying at times and I have considered giving up on the mestinon because of this, but with a little pre and pro biotics and fiber I seem to handle it mostly. I do have the sweating but was not aware this was also a side effect until today. Fun and games.
I’m looking into this but there is a doctor shortage in my area at the moment. I really like my neurologist but she is the only neurologist in Providence Everett area and I’m not sure where the disconnect is in communication. I recommend starting with this list, filtering your results by preference, and start calling one by one to see if any are taking new patients and treating Myasthenia gravis 😀 https://doctor.webmd.com/providers/condition/myasthenia-gravis-mg/rhode-island/providence - Jodi, Team Member
I've recently started pyridostigmine in the last week. I'm on 30mg 3 times a day at the moment and I can't tell you the difference it's made. My eyes are less droopy, my neck muscles are so much better, my double vision has improved. I hadn't realised how bad they actually were. like
mentions some of the side effects are welcome. I've had chronic dry mouth forever and so the excess saliva is not at all bad. Today I got my first helping of muscle twitches and cramps from waist down. Mainly lower back, quads and calf muscles but completely manageable. A few have mentioned bladder issues , which pre medication I felt like I needed to go all the time whereas now it's still very frequent but it feels more normal like at least I will have times of not feeling like I need to go but then get urgency. I used to get super bad nausea from ?gastroparesis and reflux. The reflux has reduced by about 90% and so whilst the medication makes me nauseous it's less than the nausea from before. A proper Mish mash of good and bad but I'm very grateful for it. thanks for your support on here, it's invaluable what people can access here. I can tell you really care about the community 🙂 I appreciate it! Our moderators all relate to everyone here, so it is very fulfilling work we do 😀 Have a blessed day - Jodi, Team Member
, when I started Mestinon the intense front of leg, foot cramps stopped immediately. Only have had calf cramps while also sick with Covid since. Runny nose is so bad need paper towel and attorney felt that would interfere with working. Had loose stools initially but not to medical definition of diarrhea. This was a good thing as for years before had constipation by definition no matter how much fiber I took, abd was distended and muscles were so lax. Also had several bouts of diverticulits. Having stools easily was wonderful, also was start of 40 lb weight loss. Not sure if urinary stress and urge incontinence is from MG or med, has been worse in last year. I also have times of crushing fatigue and fall back on my lifelong habit of a strong cup of tea which of course doesn't work. Had severe shortness of breath for years before got med,actually got better on mestinon and breath stacking, bipap. The shortness of breath now is only when I massively overdue physically and resolves with rest and take a bolus dose. The urinary issues I see reported by most people with MG. It is just starting to gain recognition as a characteristic MG symptom. But many, if not most, doctors are not yet accepting this. People experience frequent urination, inability to fully empty the bladder, and little warning of the need to urinate, often resulting in incontinence. Medicines can also worsen urinary issues.
- Jodi, Team Member
consist stomach ache, cramps and diarrhea, often with vomiting. 
I had all of that too. Did you have to get prescribed other medications on top of the mestinon to help with the side effects? For me I had the cramping in my stomach really bad to the point where it felt like my stomach was on fire. My doctor prescribed me medication for stomach ulcers which I thought was strange, but it did help. - Jazmin (team member) Unfortunately, these are all common with Mestinon due to its cholinergic agents. The cholinergic component mimics acetylcholine and/or butyrylcholine in the body, acting as a neurotransmitter. Excess amounts of this in the body can cause the side effects you're experiencing.
- Jodi, Team Member
