Extended release pyridostigmine?
 

Can someone tell me if the extended release version of pyridostigmine can be cut in half? My doctor doesn't know, and what I've been able to look up online isn't clear to me. If a pill is scored, then it can be cut in half, right?

I'm only using 15-30mg of medicine every 3 hours or so, so the extended release 60mg formulation is much more than I need so far, is why I am questioning cutting the pill in half.

Your best bet is to consult your pharmacist. It is a rare doctor who understands drugs overall. The printout given to you at the time you fill the prescription usually has information about cutting or crushing a dosage form.

There is information on the net, like this:
Mestinon Timespan (pyridostigmine) medical facts from Drugs.com

It is easier to find information using the brand name most times.

If a brand name drops its patent, the generic may not be exactly the same after that when made.

Hi Winic1,

You should ask your pharmacist or your doctor. Generally, timed-release tablets cannot be cut in half, but only they can tell you. They work differently than standard pills, and cutting them in half can often alter the way they work. Please consult your pharmacist or your doctor.

Take care,
Erin

NO, it cannot be split. Doing so would affect the dosing release of the drug. You wouldn't want 180 mg. of it all at once, right?

Mrs D already posted this, but I'm doing it again! This is not the only source that clearly states not to split the drug (or crush it).

Mestinon Timespan (pyridostigmine) medical facts from Drugs.com

If the Timespan is more than you need, then why are you taking it? To avoid the waking up every three hours needing more Mestinon (as I have to do)?

None of the Mestinon drugs can be put in a fridge, either. I know that humidity tends to crumble the Mestinon tablets, but putting them in a fridge reduces the potency of the drug.

Are you not doing well?

Annie

You'll notice that the SR are scored in the middle that's for the Valeant Brand not sure about generics and I was told by my Pharmacist that YES you can break in half but to make sure not to CRUSH the pill, my Nuro has also confirmed me that it was okay​...SR can not be crushed, when I couldn't swallow I could only take the regular 60mg as they can be crushed...

Okay, then, Snoel. I guess they started scoring them. Seems a bit counterproductive. Why not just take the regular tablets then?!

It has a slower release, longer lasting I'm taking a full strength at bedtime, I tried taking half and it didn't give me enough reserve till morning...

When I ran out of the 60, I split the 180 mg in half to take in its place.

I don't like the time released Mestinon. They don't seem to work 24 hours, more like six hours in my body.

Personally, I like the 60 mg of Mestinon. They work for four hours in my body, but at least they are consistent in that they work for four hours.

My doctors said my body needs more Mestinon, and I need to take the 60 mg at each meal and the 180 at night.

That seemed to work for me for 9 months, but now, the doctor wants to put me on prednisone. I hate to swell up like a bean, so I've been resisting it.

Some days or better than most, but the majority of them prove I need to consider taking the prednisone.

I hope you don't have to go on Predisone, l was on it for a little over a year and I really didn't like it all the side effects they're awful!!! I've been off now for a year and still having issues with side effects, are you on any type of immune surpressent of any kind like Imuran/Azathioprine, I'm taking 200mg a day plus Mestinon during daytime and 180 SR at bedtime and doing fairly good.

I'm sure others will Chime in to attest, sometimes you have no choice depending on situation, I don't want you contradicting you're Doctor I'm just sharing my experience from past...

Good luck.

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.

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....