Pyridostigmine Bromide Injection

Adult dosage

(Oral: tablets) Adults: Administer 60-180㎎ of pyridostigmine bromide per day orally in 3 divided doses. Adjust the dose as appropriate according to age and symptoms. (Injection) Adults: 1. Reversal agent or antagonist for nondepolarizing muscle relaxants before or after surgery: The usual dose is 10-20㎎ (0.1-0.25㎎ per kg of body weight) of pyridostigmine bromide. When this medicine is administered intravenously, it is preferable to administer atropine sulfate hydrate 0.6-1.2㎎ or glycopyrrolate (in an amount that can produce an effect equivalent to atropine) immediately before or at the same time as this medicine to reduce adverse effects such as bradycardia or excessive secretion. 2. 1) For myasthenic crisis before or after surgery and during or after delivery: Administer an amount equivalent to 1/30 of the oral dose (2-6㎎) by intramuscular injection or slow intravenous injection. 3) To maintain adequate muscle tone in a pregnant woman during labor or to protect the newborn immediately after delivery: Inject 1 hour before the second stage of labor.

Children's dosage

2) In newborns born to mothers with symptoms of myasthenia who have respiratory distress, difficulty swallowing, or temporary difficulty feeding: Administer an amount equivalent to 0.05-0.15㎎ per kg of body weight by intramuscular injection.

This medication is in an ampoule form, so there is a risk of glass fragments mixing with the injection solution when cutting the container; therefore, it is necessary to cut the container very carefully when using it. Particular caution should be taken when administered to children or the elderly. This medication should not be used in certain patients. It should be avoided in individuals who are allergic to this medication or similar medications, those with obstructions or spasms in the digestive or urinary tracts, those with asthma or bronchitis, those with inflammation in the eyes, those with hyperthyroidism, individuals with abnormal muscle tension, patients with Parkinson's disease, those in a state of shock after surgery, and those who have received certain muscle relaxants. When using this medication, particular caution should be exercised in patients with impaired kidney function, those with a history of ulcers or surgeries in the stomach, patients with diabetes, those with liver dysfunction, individuals with heart failure or who have recently experienced a myocardial infarction, and those with arrhythmias, bradycardia, or hypotension; regular liver function tests are recommended. Overdosage of this medication can lead to severe side effects such as respiratory muscle paralysis, abdominal pain, diarrhea, sweating, pupil constriction, muscle spasms, and more. If these symptoms occur, immediately discontinue the administration of the drug and, if necessary, administer atropine intravenously to alleviate side effects; artificial respiration or tracheostomy may be needed to secure the airway. Additionally, possible side effects of this medication include diarrhea, nausea, vomiting, abdominal pain, tearing, sweating, increased bronchial secretions, and vascular congestion; in severe cases, atropine can be used to alleviate symptoms. If muscle spasms or skin rashes occur, usage should be discontinued immediately. Patients with myasthenia gravis may experience a sudden worsening of symptoms or respiratory distress with this medication; therefore, it should be determined whether the exacerbation of symptoms is due to myasthenia or a cholinergic crisis and appropriate action should be taken. This medication is primarily excreted through the kidneys; thus, patients with impaired kidney function should start at a lower dose and adjust based on their condition. Temporary bradycardia may occur following administration, so care is needed. Moreover, this medication may exhibit exacerbated side effects when used with certain muscle relaxants, thus co-administration should be avoided. Caution should also be exercised when combined with parasympathetic antagonists, as side effects could be hidden, increasing the risk of overdose. Women who are pregnant or breastfeeding should use this medication only if the benefits outweigh the risks, as safety during these periods is not well established. During breastfeeding, it is advisable to avoid administration or discontinue breastfeeding if possible. The elderly are likely to have reduced kidney function, thus starting at a lower dose and closely monitoring the patient's condition is essential during treatment. If side effects occur due to overdosing, immediate discontinuation of the drug and intravenous administration of atropine is necessary, along with emergency measures such as artificial respiration if needed.

• Respiratory muscle paralysis
• myoclonic jerks
• abdominal pain
• diarrhea
• sweating
• relaxation
• miosis
• nausea
• vomiting
• abdominal fullness

This medication is sensitive to light; therefore, it should be stored in a tightly sealed container that prevents light exposure. Additionally, it is important to maintain the medication at room temperature between 1 degree and 30 degrees Celsius to preserve its efficacy.

Appearance

Brown ampoule containing a colorless transparent liquid

Package unit

Domestic use - 50 ampoules/box [1 milliliter/ampoule]