Aricept

Antimyasthenics are the drugs used to treat myasthenia gravis.

Myasthenia gravis is a rare diseases characterized by weakness and early fatigue of muscles which are under voluntary control.

It is caused by a breakdown in the normal communication between nerves and muscles.

These drugs are Pyridostigmine, Neosyigmine, Ambenonium.

These drugs are available only with your doctor’s prescription and are present in the following forms,

• Tablet
• Syrup
• Tablet, Extended Release
• Capsule, Extended Release
• Solution
• Tablet, Disintegrating
• Capsule

Before starting the treatment your doctor should be informed about condition such as,

Allergy

Inform your doctor if you are allergic to any food, preservatives, dyes, or had an allergic reaction when you used this drug before.

Children

It does not cause any different side effects from adults.

Elderly

This medicine does not cause any different side effects or problem than it does in younger adults.

Pregnancy

It is not known to cause any birth defects. However, temporary muscle weakness has been reported in some newborn babies.

Breast Feeding

There are no adequate studies done which prove that these medicines pass into breast milk. If you are using them while nursing, discuss it with your doctor for possible risk factors.

Drug Interactions

They may interact with other drugs.

Your doctor should be informed of any other medicines which you are taking. He may want to change the dosage or drug.

Some of them are listed below,

• Amifampridine
• Atropine
• Bepridil
• Cisapride
• Dronedarone
• Fluconazole
• Ketoconazole
• Mesoridazine
• Metoclopramide
• Pimozide
• Piperaquine

This is not the complete list of drugs. You should inform your doctor before taking any new medicine.

Other Medical Problem

Several other conditions may reduce its effectiveness.

Make sure you inform your doctor of conditions such as,

• Intestinal blockage
• Urinary tract blockage or infection

Use it exactly as your doctor directed. Read the medication guide carefully. Ask your pharmacist if you have any queries.

Take this medicine with food or milk as it may lessens its side effects.

Your 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.

Dosage

It is different for different patients. Dosage mentioned below is an average dose. You must follow your doctor’s instructions.

Different medicines with different doses for myasthenia gravis are mentioned below,

Ambenonium

• Adults and teenagers: 5 milligrams (mg) three or four times per day.
• Children: 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, your doctor will adjust the dose of your child.

Pyridostigmine

For myasthenia gravis

Syrup and tablet forms:

• Adults and teenagers: 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: 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)

• Adults and teenagers: 180 to 540 mg one or two times per day.
• Children: Dose must be determined by your doctor.

For injection dosage form:

• Adults and teenagers: 2 mg injected into a muscle or vein, every two or three hours.
• Children: 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.

Neostagmine

Tablet forms for myasthenia gravis

• Adults and teenagers: 15 mg every three or four hours. Then, the dose is 150 mg taken over a twenty four hour period.
• Children: 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.

Injection forms:

For myasthenia gravis

• Adults and teenagers: 500 micrograms (mcg) injected into a muscle or under the skin.
• Children: It is usually 10 to 40 microgram (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: 250 to 500 mcg, injected into a muscle or under the skin, as needed.
• Children: Use and dose must be determined by your doctor.

Missed dose

If you miss a dose, take it as soon as you remember it. If it almost a time for your next dose skips the miss dose and continue your daily schedule. Do not double the dose.

Storage

Store it at room temperature.

Keep it away from children.

All medicines have some side effects. Some people may experience none or minor side effects.

Consult with your doctor if they become problematic or frequent

More common are,

• Diarrhea
• Increased sweating
• Increased watering of mouth
• Nausea or vomiting
• Stomach cramps or pain

Less common are,

• Frequent urge to urinate
• Increase in bronchial secretions
• Unusually small pupils
• Unusual watering of eyes

This is not a complete list of side effects and others may occur.

Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088.