NeuroTalk Support Groups - Extended release pyridostigmine?

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- - Extended release pyridostigmine? (https://www.neurotalk.org/myasthenia-gravis/246952-extended-release-pyridostigmine.html)

Quote:

Originally Posted by Poetist (Post 1244061)

Snoel, what's the next step after Mestinon other than prednisone? I would love to know, because if I can avoid it that would be great.

By the way, my mother was on prednisone for years, but it didn't seem to affect her. I don't know why she was on it, but she doesn't have MG.

Imuran/Azathioprine seems to be the most popular for refractive MG...I'm also doing IVIg every 3 weeks.

My doctor ordered the pyridostigmine Br Extended Release for me now, to replace the regular 60mg pills I was taking 4-5 times a day.

Now that I have bottle in hand, I called the manufacturer about whether it is okay to cut it in half or not. The pills are scored, "functionally scored" is the official wording on their literature.

What I have is Alvogen Pyridostigmine Bromide Extended-Release Tablets 180mg. Alvogen's customer service line has told me that yes, you can cut the tablet in half to get effectively a lower dose ER pill. IF stored properly, which means in a tightly sealed dark container with dessicant present, to protect it from humidity and light, a cut tablet is good for up to 90 days from the date it was cut.

So, for Alvogen Pyridostigmine Br Extended-Release Tablets that are functionally scored, the answer is YES, you can halve them.

If you have another brand/manufacturer, I would suggest looking up their customer service phone number online, and calling and asking.

Quote:

Originally Posted by winic1 (Post 1251848)

Oh, fyi, I had asked because I am very susceptible to side effects from everything, and the write ups for the Py-ER all said that side effects are more likely from the ER pills, so starting with a lower dosage is usually better for me. Since three 60mg regular pills would be expected to cover 9-12 hours (taken every 3-4 hours), and the ER pills seem, from all that is written by companies and regular people, to last more like 6 hours, or 6-9 hours, the logic my mind comes up with is that at some point the dosage from the slow release of the ER pills must go higher than 60mg, hence the increased incidence of side effects from ER pills. Or, it could be from the other stuff that goes into the making of the pill. Either way, I prefer to test out new stuff at lower doses, that way if they make me miserable (or do bad things like act like overdoses or trigger allergic reaction) it's less than full strength would have done.

And I tried discussing with my doctor. She didn't know. As in had no idea, and no interest in finding out. Yeah, she's terrible, but she's the best I've got, or ever had.

Wish me luck. Half a pill going down now....