2.	What should I know before I take Mestinon?
            
         
            
            Do not take if you have ever had an allergic reaction to Mestinon or any of the ingredients
               listed at the end of the CMI or have known hypersensitivity to anticholinesterase
               agents like medicines used in Alzheimer's disease, ambenonium, bromides and neostigmine.
            
            
               Talk to your doctor if you have any other medical conditions, take any other medicines,
                  or are pregnant or plan to become pregnant or are breastfeeding.
               
            
            Talk to your doctor if you have or have had any of the following medical conditions:
               epilepsy, problems with your lungs such as asthma or bronchitis, heart problems, slow
               or irregular heartbeats, stomach ulcer kidney and thyroid problems. For more information,
               see Section 
2. What should I know before I use Mestinon? in the full CMI.
 
             
         
            
            
3.	What if I am taking other medicines?
            
         
            
            Some medicines may interfere with Mestinon and affect how it works. 
            
            
             
         
            
            
4.	How do I take Mestinon?
            
         
            
            The usual adult dose is one to three Mestinon 60 mg tablets two to four times daily.
               
            
            In severe cases, one to three Mestinon Timespan 180 mg tablets can be taken once or
               twice daily.
            
            
             
         
            
            
5.	What should I know while taking Mestinon?
            
         
            
            
               
                  
                  
               
               
                  
                     
                     | 
                        
                         
                           Things you should do
                            
                         | 
                     
                     
                        
                        
                         Remind any doctor, dentist, pharmacist, surgeon or anaesthetist you visit that you
                           are taking Mestinon. 
                        
                        If you are going to have surgery, tell the surgeon or anaesthetist that you are taking
                           this medicine. 
                        
                        Contact your doctor immediately if you become pregnant while taking Mestinon. 
                        
                         | 
                     
                  
                     | 
                        
                         
                           Things you should not do
                            
                         | 
                     
                        
                        
                         Do not take Mestinon to treat any other complaints unless your doctor tells you to 
                        
                         | 
                  
                  
                     | 
                        
                         
                           Looking after your medicine
                            
                         | 
                     
                        
                        
                         Keep your tablets in the bottle until it is time to take them. 
                        
                        Keep your tablets in a cool dry place and keep out of reach of children. 
                        
                         | 
                  
               
            
            
            
             
         
            
            
6.	Are there any side effects?
            
         
            
            Common side effects include nausea and vomiting, diarrhoea, stomach cramps or pains,
               increased saliva, chest congestions, low blood pressure, skin rash, muscle cramps
               and twitching, excessive contraction of the pupil of the eye and excessive sweating.
            
            Serious side effects include slowed heart rate, shortness of breath, severe rash,
               irritation, swollen face. Seek immediate medical attention if you experience any of
               these.
            
            
            
            
             
         
            
            
            
         
            
            
               Active ingredient(s):
               Pyridostigmine Bromide
               
            
            
            
            
            
            Full Consumer Medicine Information (CMI)
            
            This leaflet provides important information about using Mestinon. You should also speak to your doctor or pharmacist if you would like further information
                  or if you have any concerns or questions about using Mestinon.
               
            
            
               Where to find information in this leaflet:
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
             
         
            
            
1.	Why am I taking Mestinon?
            
         
            
            
               Mestinon contains the active ingredient pyridostigmine bromide. Mestinon belongs to a group of medicines called cholinergic antimyasthenics and works
               by preventing the breakdown of a chemical called acetylcholine. Acetylcholine is needed
               to stimulate muscle movement.
            
            
               Mestinon is used to treat myasthenia gravis. This is a condition whereby you have
                  muscle weakness and tiredness especially on repeated use.
               
             
         
            
            
2.	What should I know before I take Mestinon?
            
         
            
            
Warnings
            
         
            
            Do not take Mestinon if:
            
            
            you are allergic to pyridostigmine bromide, or any of the ingredients listed at the
               end of this leaflet. Always check the ingredients to make sure you can take Mestinon.
            
            you are allergic to other anticholinesterase agents like medicines used in Alzheimer's
               disease, ambenonium, bromides and neostigmine. Ask your doctor or pharmacist if you
               are not sure if you are taking any of these medicines.
Symptoms of an allergic reaction may include:
               
               
shortness of breath
               
               wheezing or difficulty breathing
               
               swelling of the face, lips, tongue or other parts of the body
               
               rash, itching or hives on the skin
               
                
            
            if you have intestinal blockage or urinary tract blockade or urinary tract infection.
               Mestinon may make the condition worse.
            
            it is past the expiry date printed on the pack or if the packaging is torn or shows
               signs of tampering.
            
             
         
            
            Check with your doctor if you:
            
            
            have any other medical conditions including:
               
               
epilepsy
               
               problems with your lungs such as asthma or bronchitis
               
               heart problems
               
               slow or irregular heart beats
               
               stomach ulcer
               
               kidney and thyroid problems
               
                
            
            take any medicines for any other condition
            
            
            During treatment, you may be at risk of developing certain side effects. It is important
               you understand these risks and how to monitor for them. See additional information
               under Section 
6. Are there any side effects? 
 
             
         
            
            Pregnancy and breastfeeding
            
            Check with your doctor if you are pregnant or intend to become pregnant.
            
            Talk to your doctor if you are breastfeeding or intend to breastfeed.
            
            Temporary muscle weakness can occur in some newborn babies where those mothers have
               taken antimyasthenics during pregnancy.
             
         
            
            
3.	What if I am taking other medicines?
            
         
            
            Tell your doctor or pharmacist if you are taking any other medicines, including any
               medicines, vitamins or supplements that you buy without a prescription from your pharmacy,
               supermarket or health food shop.
            
            
               Some medicines may interfere with Mestinon and affect how it works.
               
            
            
               These include:
               
            
            
            muscle relaxants such as suxamethonium
            
            atropine contained in medicines for travel sickness and stomach cramps, or use in
               surgery (injection) or used as an antidote to insecticide poisoning (tablets)
            
            aminoglycoside antibiotics such as gentamicin which are used to treat bacterial infections
            
            some general and local anaesthetics
            
            medicines to treat abnormal heart rhythms
            
            methocarbamol, a medicine to treat muscle pain and spasms
            
            dexpanthenol.
            
            
            
               Check with your doctor or pharmacist if you are not sure about what medicines, vitamins
                  or supplements you are taking and if these affect Mestinon.
               
             
         
            
            
4.	How do I take Mestinon? 
            
         
            
            How much Mestinon to take:
            
            
            In adults, the usual dose is one to three Mestinon 60 mg tablets, two to four times
               daily. In severe cases, one to three Mestinon Timespan 180 mg tablets may be taken
               once or twice daily.
            
            The above doses include only the average doses of these medicines and may be different
               from what your doctor has instructed. If your dose is different, do not change it
               unless your doctor tells you to do so.
            
            The number of tablets you take depends on the strength of Mestinon and the number
               of doses you take each day. How long you take Mestinon depends on your medical condition.
            
            If you have difficulty in eating, your doctor will adjust your dosage so that you
               may need to take larger doses at times of greatest fatigue e.g. 30-45 minutes before
               meals.
            
             
         
            
            How to take Mestinon
            
            Swallow the tablets whole with a full glass of water.
             
         
            
            When to take Mestinon
            
            Mestinon should be used as needed. Follow your doctor's orders or the directions on
               the label.
             
         
            
            If you forget to take Mestinon
            
            Mestinon should be used as needed. If you miss your dose at the usual time, take it
               when you remember. 
            
            
               If it is almost time for your next dose, skip the dose you missed and take your next
                  dose when you are meant to. 
               
            
            
               Do not take a double dose to make up for the dose you missed.
               
             
         
            
            If you take too much Mestinon
            
            If you think that you have taken too many Mestinon tablets, you may need urgent medical
               attention.
            
            
               You should immediately:
               
            
            
            phone the Poisons Information Centre 
(by calling
               13 11 26), or
            
            contact your doctor, or
            
            go to the Emergency Department at your nearest hospital.
            
            
            
               You should do this even if there are no signs of discomfort or poisoning.
               
             
         
            
            
5.	What should I know while taking Mestinon?
            
         
            
            Things you should do:
            
            
            If you are going to have surgery, tell the surgeon or anaesthetist that you are taking
               Mestinon. It may affect other medicines used during surgery.
            
            If you are about to have any blood tests, tell your doctor that you are taking this
               medicine. It may interfere with the results of some tests.
            
            Continue to use Mestinon until your doctor tells you to stop.
            
             
         
            
            Call your doctor straight away if you:
            
            
            Become pregnant while taking Mestinon tablets. 
            
            
            Remind any doctor, dentist or pharmacist you visit that you are using Mestinon.
             
         
            
            Things you should not do
            
            
            Do not take Mestinon to treat any other complaints unless your doctor tells you to
            
            Mestinon may not restore your muscle strength to normal and you should not increase
               your dose above the maximum response level in an attempt to relieve all symptoms.
            
             
         
            
            Driving or using machines
            
            
               Be careful before you drive or use any machines or tools until you know how Mestinon
                  affects you.
               
             
         
            
            Drinking alcohol
            
            
               Tell your doctor if you drink alcohol.
               
             
         
            
            Looking after your medicine
            
            Follow the instructions on the carton on how to take care of your medicine properly.
            
            Mestinon 10 and 180 mg: Store below 30°C.
            
            Mestinon 60 mg: Store below 25°C.
            
            Store in a cool dry place away from moisture, heat or sunlight; for example, do not
               store it:
            
            
            in the bathroom or near a sink, or
            
            in the car or on window sills.
            
            
            
               Keep it where young children cannot reach it.
               
             
         
            
            Getting rid of any unwanted medicine
            
            If you no longer need to use this medicine or it is out of date, take it to any pharmacy
               for safe disposal.
            
            Do not use this medicine after the expiry date.
             
         
            
            
6.	Are there any side effects?
            
         
            
            All medicines can have side effects. If you do experience any side effects, most of
               them are minor and temporary. However, some side effects may need medical attention.
               
            
            See the information below and, if you need to, ask your doctor or pharmacist if you
               have any further questions about side effects.
             
         
            
            Less serious side effects
            
            
            
            
             
         
            
            Serious side effects
            
            
            
            
               Tell your doctor or pharmacist if you notice anything else that may be making you
                  feel unwell. 
               
            
            Other side effects not listed here may occur in some people.
             
         
            
            Reporting side effects
            
            After you have received medical advice for any side effects you experience, you can
               report side effects to the Therapeutic Goods Administration online at 
www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of
               this medicine.
 
            
            
               Always make sure you speak to your doctor or pharmacist before you decide to stop
                  taking any of your medicines.
               
             
         
            
            
7.	Product details
            
         
            
            Mestinon is only available with a doctor's prescription.
             
         
            
            What Mestinon contains
            
            
               
                  
                  
               
               
                  
                     
                     | 
                        
                         
                           Active ingredient 
                            
                        
                        
                           (main ingredient)
                            
                         | 
                     
                     
                        
                         Pyridostigmine Bromide 
                         | 
                     
                  
                     | 
                        
                         
                           Other ingredients
                            
                        
                        
                           (inactive ingredients)
                            
                         | 
                     
                        
                         
                           Mestinon 10 mg:
                            
                        
                        colloidal anhydrous silica 
                        
                        lactose monohydrate 
                        
                        magnesium stearate 
                        
                        maize starch 
                        
                        pregelatinised potato starch 
                        
                        purified talc 
                        
                        
                           Mestinon 60 mg:
                            
                        
                        Acacia 
                        
                        colloidal anhydrous silica 
                        
                        hard paraffin 
                        
                        iron oxide red 
                        
                        iron oxide yellow 
                        
                        liquid paraffin 
                        
                        magnesium stearate 
                        
                        maize starch 
                        
                        povidone 
                        
                        pregelatinised potato starch 
                        
                        purified talc 
                        
                        rice starch 
                        
                        sucrose 
                        
                        
                           Mestinon 180 mg:
                            
                        
                        calcium phosphate 
                        
                        carnauba wax 
                        
                        colloidal anhydrous silica 
                        
                        magnesium stearate 
                        
                        zein 
                         | 
                  
                  
                     | 
                        
                         
                           Potential allergens
                            
                         | 
                     
                        
                         Contains sugars (lactose and sucrose) 
                         | 
                  
               
            
            
            
               Do not take Mestinon if you are allergic to any of these ingredients.
               
            
            
             
         
            
            What Mestinon looks like
            
            Mestinon 10 mg: Round, biconvex, white to off-white tablet with no markings. Packed
               in bottles of 50, 100# or 250# tablets. (AUST R 13747).
            
            Mestinon 60 mg: Round, biconvex, pale orange, sugar coated tablet with no markings.
               Packed in bottles of 150 tablets. (AUST R 13748).
            
            Mestinon 180 mg: Round, biplanar, grey-yellow tablet with a marking 'M180' on one
               side and scored on the other side. Packed in bottles of 50 or 100# tablets. (AUST
               R 13749).
            
            #: Not currently distributed in Australia
            
             
             
         
            
            Who distributes Mestinon
            
            iNova Pharmaceuticals (Australia) Pty Limited
            
            Level 10, 12 Help Street
            
            Chatswood NSW 2067
            
            Tel: 1800 630 056
            
            
            
            This leaflet was prepared in March 2023.