Last update Aug. 27, 2022

Pyridostigmine Bromide

Compatible

Safe product and/or breastfeeding is the best option.

Reversible cholinesterase inhibitor used for treatment of Myasthenia Gravis.

It is excreted into breast milk at undetectable levels (Skoglund 1978) or clinically non-significant (Hardell 1982, Djelmis 2002) without harmful effects having been observed in infants whose mothers were treated (Skoglund 1978, Hardell 1982).

Plasma levels in such infants were undetectable (Hardell 1982).

Because of a low oral bioavailability it seems even more unlikely the pass to the infant’s plasma through ingested breastmilk, except in preterm infants and immediate neonatal period, when there may be an increased intestinal permeability.

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001). WHO 2002 List of Essential Medicines: compatible with breastfeeding. (WHO 2002)


See below the information of this related product:

Alternatives

We do not have alternatives for Pyridostigmine Bromide since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pyridostigmine Bromide in other languages or writings:

Group

Pyridostigmine Bromide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Pyridostigmine Bromide in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 12 - 19 %
Molecular weight 261 daltons
Protein Binding 0 %
VD 0.5 - 1.8 l/Kg
Tmax 2 hours
3.3 hours
M/P ratio 0.4 - 1.1 -
Theoretical Dose 0.004 mg/Kg/d
Relative Dose 0.1 - 0.2 %
Ped.Relat.Dose 0.05 %

References

  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  2. Klehmet J, Dudenhausen J, Meisel A. [Course and treatment of myasthenia gravis during pregnancy]. Nervenarzt. 2010 Abstract
  3. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  4. Djelmis J, Sostarko M, Mayer D, Ivanisevic M. Myasthenia gravis in pregnancy: report on 69 cases. Eur J Obstet Gynecol Reprod Biol. 2002 Abstract
  5. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  6. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  7. Hardell LI, Lindström B, Lönnerholm G, Osterman PO. Pyridostigmine in human breast milk. Br J Clin Pharmacol. 1982 Abstract
  8. Giwa-Osagie OF, Newton JR, Larcher V. Obstetric performance of patients with myasthenia gravis. Int J Gynaecol Obstet. 1981 Abstract
  9. Skoglund RR, Roberts CC, Huddlestone J. The role of anti-acetylcholine receptor antibody in neonatal myasthenia gravis. Bull Los Angeles Neurol Soc. 1978 Abstract

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