Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Pyridostigmine bromide
Drug ID BADD_D01882
Description Myasthenia gravis is an autoimmune disease involving dysfunction at the neuromuscular junction, most commonly due to autoantibodies directed against the acetylcholine receptor (AChR), which results in muscle tone loss, muscle weakness, and fatigue.[A231004] Acetylcholinesterase inhibitors have been the symptomatic treatment of choice in myasthenia gravis since the 1930s with the early use of [physostigmine] and [neostigmine]. By inhibiting the breakdown of acetylcholine in the neuromuscular junction, they increase signalling and relieve symptoms.[A231004, L32408, L32413] Pyridostigmine is the current drug of choice, with superior pharmacokinetics and reduced side effects compared to [neostigmine].[L32408, L32413] In addition to treating myasthenia gravis, pyridostigmine is used to reverse neuromuscular blocks, relieve symptoms in congenital myasthenic syndromes, and protect against certain nerve agents, notably during the Gulf War.[A231009, A231014, L32413, L32418] Pyridostigmine was granted initial FDA approval on April 6, 1955, as an oral tablet. Possible dose forms have been expanded to include extended-release tablets, syrups, and injections, marketed under various brand and generic names.[L32408, L32413]
Indications and Usage Pyridostigmine is indicated for the treatment of myasthenia gravis.[L32408] When administered intravenously, it is indicated for the reversal or antagonism of the neuromuscular blocking effects of nondepolarizing muscle relaxants.[L32413] Pyridostigmine has also been used as a prophylactic agent against irreversible organophosphorus acetylcholinesterase inhibitors, primarily in a military capacity.[L32418]
Marketing Status approved; investigational
ATC Code N07AA02
DrugBank ID DB00545
KEGG ID D00487
MeSH ID D011729
PubChem ID 7550
TTD Drug ID D09KKU
NDC Product Code 46016-1012; 51927-4441; 24689-104; 47781-335; 64980-220; 66689-406; 68682-301; 71052-386; 0187-3012; 63739-969; 65841-819; 68084-494; 69784-130; 0781-3040; 45941-3051; 71666-011; 0115-2134; 0187-3013; 68682-302; 68682-307; 71930-028; 0904-6622; 0115-1404; 68382-659; 16571-833; 73152-028; 0115-3511; 65571-0002; 0187-3010; 58657-810
UNII KVI301NA53
Synonyms Pyridostigmine Bromide | Bromide, Pyridostigmine | Pyridostigmine | Mestinon
Chemical Information
Molecular Formula C9H13BrN2O2
CAS Registry Number 101-26-8
SMILES C[N+]1=CC=CC(=C1)OC(=O)N(C)C.[Br-]
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice.
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal pain07.01.05.002--
Asthenia08.01.01.001---
Diarrhoea07.02.01.001--
Hyperhidrosis08.01.03.028; 23.02.03.004--
Miosis06.05.03.003; 17.02.11.002---
Muscle contractions involuntary15.05.03.008; 17.05.03.001---
Muscle spasms15.05.03.004--
Nausea07.01.07.001--
Salivary hypersecretion07.06.01.009---
Vomiting07.01.07.003--
Gastrointestinal hypermotility07.02.04.005---
Increased bronchial secretion22.12.01.002---
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