Drug/Small Molecule:
pyridostigmine

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The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • Pyridine N-Oxide
  • Pyridostigmine Bromide
  • Pyridostigmine Bromine
  • Pyridostigminum
Trade Names
  • Mestinon
  • Mestinon-SR
  • Regonol
Brand Mixture Names

PharmGKB Accession Id:
PA451185

Description

A cholinesterase inhibitor with a slightly longer duration of action than neostigmine. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.

Source: Drug Bank

Indication

For the treatment of myasthenia gravis.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Pyridostigmine inhibits acetylcholinesterase in the synaptic cleft by competing with acetylcholine for attachment to acetylcholinesterase, thus slowing down the hydrolysis of acetylcholine, and thereby increases efficiency of cholinergic transmission in the neuromuscular junction and prolonges the effects of acetylcholine.

Source: Drug Bank

Pharmacology

Pyridostigmine is a parasympathomimetic and a reversible cholinesterase inhibitor. Since it is a quaternary amine, it is poorly absorbed in the gut and doesn't cross the blood-brain barrier. Pyridostigmine has a slightly longer duration of action than NEOSTIGMINE. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.

Source: Drug Bank

Food Interaction

Take with food to decrease adverse effects.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hydrolysis by cholinesterases and by liver.

Source: Drug Bank

Absorption

Poorly absorbed from the GI tract with an oral bioavailability of 7.6 +/- 2.4%.

Source: Drug Bank

Half-Life

3 hours following oral administration.

Source: Drug Bank

Chemical Properties

Chemical Formula

C9H13N2O2

Source: Drug Bank

Isomeric SMILES

C[n+]1cccc(c1)OC(=O)N(C)C

Source: OpenEye

Canonical SMILES

CN(C)C(=O)OC1=C[N+](C)=CC=C1

Source: Drug Bank

Average Molecular Weight

181.2117

Source: Drug Bank

Monoisotopic Molecular Weight

181.09770267

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Drug Targets

Gene Description
ACHE (source: Drug Bank)

Drug Interactions

Drug Description
pyridostigmine The corticosteroid, betamethasone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
pyridostigmine The corticosteroid, dexamethasone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
pyridostigmine The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
pyridostigmine The corticosteroid, prednisolone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
pyridostigmine The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
betamethasone The corticosteroid, betamethasone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
corticotropin The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
corticotropin The corticosteroid, corticotropin, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
cortisone acetate The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
cosyntropin The corticosteroid, cosyntropin, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
dexamethasone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
dexamethasone The corticosteroid, dexamethasone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
fludrocortisone The corticosteroid, fludrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
hydrocortisone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
hydrocortisone The corticosteroid, hydrocortisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
methylprednisolone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
methylprednisolone The corticosteroid, methylprednisolone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
paramethasone The corticosteroid, paramethasone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
prednisolone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
prednisolone The corticosteroid, prednisolone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
prednisone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
prednisone The corticosteroid, prednisone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
succinylcholine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
triamcinolone The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
triamcinolone The corticosteroid, triamcinolone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)
pyridostigmine The corticosteroid decreases the effect of anticholinesterases (source: Drug Bank)
pyridostigmine The corticosteroid, triamcinolone, may decrease the effect of the anticholinesterase, pyridostigmine. (source: Drug Bank)

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0115-3511-01
DrugBank:
DB00545
KEGG Compound:
C07410
KEGG Drug:
D00487
PubChem Compound:
4991
PubChem Substance:
46506129
9614
Drugs Product Database (DPD):
869953
BindingDB:
50018231
ChemSpider:
4817
Therapeutic Targets Database:
DNC001171
FDA Drug Label at DailyMed:
0f56facf-1f0a-4ba5-876d-757b114dfa45

Clinical Trials

These are trials that mention pyridostigmine and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.