Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Pyridostigmine
Drug ID BADD_D01881
Description Myasthenia gravis is an autoimmune disease involving dysfunction at the neuromuscular junction, most commonly due to autoantibodies directed against the acetylcholine receptor (AChR), which results in muscle tone loss, muscle weakness, and fatigue.[A231004] Acetylcholinesterase inhibitors have been the symptomatic treatment of choice in myasthenia gravis since the 1930s with the early use of [physostigmine] and [neostigmine]. By inhibiting the breakdown of acetylcholine in the neuromuscular junction, they increase signalling and relieve symptoms.[A231004, L32408, L32413] Pyridostigmine is the current drug of choice, with superior pharmacokinetics and reduced side effects compared to [neostigmine].[L32408, L32413] In addition to treating myasthenia gravis, pyridostigmine is used to reverse neuromuscular blocks, relieve symptoms in congenital myasthenic syndromes, and protect against certain nerve agents, notably during the Gulf War.[A231009, A231014, L32413, L32418] Pyridostigmine was granted initial FDA approval on April 6, 1955, as an oral tablet. Possible dose forms have been expanded to include extended-release tablets, syrups, and injections, marketed under various brand and generic names.[L32408, L32413]
Indications and Usage For the treatment of myasthenia gravis.
Marketing Status Prescription; Discontinued
ATC Code N07AA02
DrugBank ID DB00545
KEGG ID C07410
MeSH ID D011729
PubChem ID 4991
TTD Drug ID D0O2WB
NDC Product Code Not Available
Synonyms Pyridostigmine Bromide | Bromide, Pyridostigmine | Pyridostigmine | Mestinon
Chemical Information
Molecular Formula C9H13N2O2+
CAS Registry Number 155-97-5
SMILES C[N+]1=CC=CC(=C1)OC(=O)N(C)C
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Muscle contractions involuntary17.05.03.001; 15.05.03.0080.009740%Not Available
Muscle spasms15.05.03.0040.038959%
Muscle twitching15.05.03.0050.009740%Not Available
Muscular weakness17.05.03.005; 15.05.06.0010.009740%
Myalgia15.05.02.001--
Myasthenia gravis17.05.04.001; 15.05.08.001; 10.04.05.0010.087658%
Nausea07.01.07.001--
Neck pain15.03.04.009--
Pallor24.03.04.001; 23.03.03.031; 08.01.03.032--Not Available
Paraesthesia17.02.06.005--
Pollakiuria20.02.02.007--
Pulmonary oedema22.01.03.003; 02.05.02.003--
Rash23.03.13.0010.014610%Not Available
Respiratory depression22.02.01.010; 17.02.05.0470.009740%Not Available
Respiratory distress22.02.01.0120.019480%Not Available
Respiratory failure22.02.06.002; 14.01.04.0030.008893%
Respiratory paralysis22.02.06.003; 17.01.04.010--Not Available
Salivary hypersecretion07.06.01.0090.009740%Not Available
Seizure17.12.03.001--
Septic shock24.06.02.011; 11.01.11.0040.002541%Not Available
Sinoatrial block02.03.01.0100.009740%Not Available
Somnolence19.02.05.003; 17.02.04.006--
Sputum increased22.02.03.007--Not Available
Suicide attempt19.12.01.0040.014610%
Thrombocytopenia01.08.01.0020.002541%Not Available
Thrombophlebitis24.01.02.001--Not Available
Toxic encephalopathy17.13.01.004; 12.03.01.0270.009740%Not Available
Tracheobronchitis22.07.03.010; 11.01.13.008--Not Available
Urinary incontinence20.02.02.010; 17.05.01.0080.014610%
Urticaria23.04.02.001; 10.01.06.0010.009740%
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