How to Use

Your family doctor may want you to take this drug with food or milk to help lessen the risk of side effects. If you have any questions about how you must be taking this drug, check with your family doctor.

Take this drug only as directed . Do not take more of it, do not take it more often and do not take it for a longer time than your family doctor ordered. To do so may increase the risk of side effects.

If you are taking this drug for myasthenia gravis :

• When you first begin taking this drug, your family doctor may want you to keep a daily record of:
  • the time you take each dose.
  • how long you feel better after taking each dose.
  • how long you feel worse.
  • any side effects that occur.

This is to help your family doctor decide whether the dose of this drug must be increased or decreased and how often the drug must be taken in order for it to be most effective in your condition.

Dosage

The number of tablets or teaspoonfuls of syrup that you take depends on the strength of the drug. Always the number of doses you take each day, the time allowed between doses and the length of time you take the drug depend on the medical problem for which you are taking these medication .

For ambenonium
• For oral dosage form - tablets:
  • For myasthenia gravis:
    • Adults and teenagers At first, the dose is 5 milligrams - mg three or four times per day. Then, if needed, the dose will be adjusted by your family doctor.
    • Children The dose is based on body weight or size and must be determined by your family doctor. The total daily dose is usually 300 micrograms - mcg per kilogram - kg - 136 mcg per pound of body weight or 10 mg per square meter of body surface area. This dose may be divided into three or four smaller doses. If needed, the total daily dose will be increased to 1.5 mg per kg - 0.68 mg per pound of body weight or 50 mg per square meter of body surface area. This dose may be divided into three or four smaller doses.

For neostigmine
• For oral dosage form - tablets:
  • For myasthenia gravis:
    • Adults and teenagers At first, the dose is 15 milligrams - mg every three or four hours. Then, the dose is 150 mg taken over a twenty-four-hour period.
    • Children The dose is based on body weight or size and must be determined by your family doctor. The total daily dose is usually 2 mg per kilogram - kg - 0.91 mg per pound of body weight or 60 mg per square meter of body surface area. This dose may be divided into six to eight smaller doses.
• For injection dosage form:
  • For myasthenia gravis:
    • Adults and teenagers The usual dose is 500 micrograms - mcg injected into a muscle or under the skin.
    • Children The dose is based on body weight and must be determined by your family doctor. It is usually 10 to 40 mcg per kg - 4.5 to 18.2 mcg per pound of body weight, injected into a muscle or under the skin, every two or three hours.
  • For urinary tract or intestinal disorders:
    • Adults and teenagers The usual dose is 250 to 500 mcg, injected into a muscle or under the skin, as needed.
    • Children Use and dose must be determined by your family doctor.

For pyridostigmine
• For oral dosage forms - syrup and tablets:
  • For myasthenia gravis:
    • Adults and teenagers At first, the dose is 30 to 60 milligrams - mg every three or four hours. Then, the dose is 60 mg to 1.5 grams - usually 600 mg per day.
    • Children The dose is based on body weight or size and must be determined by your family doctor. The total daily dose is usually 7 mg per kilogram - kg - 3.2 mg per pound of body weight or 200 mg per square meter of body surface area. This dose may be divided into five or six smaller doses.
• For long-acting oral dosage form - extended-release tablets:
  • For myasthenia gravis:
    • Adults and teenagers The usual dose is 180 to 540 mg one or two times per day.
    • Children Dose must be determined by your family doctor.
• For injection dosage form:
  • For myasthenia gravis:
    • Adults and teenagers The usual dose is 2 mg, injected into a muscle or vein, every two or three hours.
    • Children The dose is based on body weight and must be determined by your family doctor. It is usually 50 to 150 micrograms - mcg per kg - 22.7 to 68.1 mcg per pound of body weight, injected into a muscle every four to six hours.

Missed dose If you miss a dose of this drug, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage To store this drug:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the tablet form of this drug in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the drug to break down.
• Keep the syrup form of pyridostigmine from freezing.
• Do not keep outdated drug or drug no longer needed. Be sure that any discarded drug is out of the reach of children.