Mestinon SR® 180 mg Sustained-Release Tablets for Myasthenia Gravis

What Mestinon SR® Is and How It Works

Mestinon SR® 180 mg is the sustained-release form of pyridostigmine bromide. It helps reduce muscle weakness in myasthenia gravis. The tablet releases medicine slowly for longer coverage. Many people use one dose at night or twice daily. YouDrugstore is a licensed Canadian pharmacy based in Manitoba, and our pharmacists review every prescription before dispensing. We ship to the US at Canadian prices, and you can still order if you need Mestinon SR without insurance.

Pyridostigmine is an acetylcholinesterase inhibitor. It increases acetylcholine at the neuromuscular junction. This helps nerves activate muscles more effectively. The sustained-release (SR) tablet is not for sudden or severe weakness. The SR form offers steadier control over several hours. The immediate-release version works faster but wears off sooner.

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Dosage and Usage

Use Mestinon SR® exactly as your prescriber directs. The SR tablet is usually taken once daily at bedtime or twice daily. Do not use the SR tablet to treat sudden symptom flares. Swallow whole with water.

• Take the SR tablet whole. Do not cut, crush, or chew.
• You may take it with food to reduce stomach upset.
• If your plan uses both SR and immediate-release tablets, follow the schedule your prescriber sets.
• If you miss a dose and it is close to the next dose, skip the missed dose. Do not double up.
• If you miss a bedtime dose and wake with weakness, ask your clinician how to adjust. Do not self-increase.

Storage and travel tips:

• Store at room temperature (15–30°C / 59–86°F) in a dry place.
• Keep tablets in the original, labeled container with the child-resistant cap closed.
• Protect from moisture and heat. Avoid bathroom storage.
• When you travel, carry it in your hand luggage with a copy of your prescription.
• Do not leave medicine in a parked car or near heat sources.

Benefits and Savings

Mestinon SR® can provide steadier symptom control overnight or between daytime doses. Many patients need fewer daily doses compared with immediate-release tablets. This can simplify daily routines and support sleep when nighttime weakness is a problem. The SR tablet helps maintain muscle strength for longer periods.

You can save 60–80% versus typical US retail prices by ordering from our Canadian pharmacy. We support patients paying out of pocket, so you can still find value without insurance. Multi-month supplies may lower the monthly cost, and we offer gentle reorder reminders so you can stay on track.

Side Effects and Safety

Many people tolerate pyridostigmine well, but some side effects may occur. Call your prescriber if symptoms are severe or persistent.

• Common: nausea, stomach cramps, diarrhea, increased saliva, sweating, flushing, increased urination, mild muscle twitching.
• Less common: vomiting, blurred vision, runny nose, abdominal discomfort.
• Serious: severe muscle weakness, shortness of breath, wheezing, very slow heartbeat, fainting, severe diarrhea or cramping, confusion. Seek urgent care for these.

Too much pyridostigmine can cause a “cholinergic” state that may resemble a myasthenic flare. Do not adjust your dose on your own. Discuss changes with your clinician. Use caution if you have asthma, COPD, slow heart rate, peptic ulcer disease, hyperthyroidism, epilepsy, or urinary or bowel obstruction. Share a full medication list with your prescriber. Interactions can occur with anticholinergic drugs, beta-blockers, some antibiotics, and magnesium-containing products. If you are pregnant or breastfeeding, review risks and benefits with your healthcare provider.

Onset Time

The SR tablet starts working more slowly than the immediate-release form. You may notice effects within 1 to 3 hours. The benefit can last about 6 to 12 hours, depending on your dose and response. Immediate-release tablets often act within 30 to 60 minutes but wear off sooner.

Compare With Alternatives

The main alternative is the immediate-release pyridostigmine tablet. It works faster and is taken several times per day. If you need quicker relief during waking hours, your clinician may prefer the immediate-release option. You can review the standard tablet on our site at Mestinon®.

Neostigmine is another cholinesterase inhibitor used less often for long-term oral therapy. Some patients also receive immunotherapy, such as corticosteroids or steroid-sparing agents, under specialist care. SR tablets should not replace emergency treatments for severe weakness or breathing problems. Your care team will choose a plan based on symptoms, comorbidities, and goals.

Combination Therapy

Some patients use a mixed schedule. For example, an SR dose at bedtime for overnight coverage and immediate-release tablets during the day. Your prescriber may also add immunomodulatory therapy if symptoms are not controlled. Physical therapy, rest, and careful pacing can support daily function.

Addressing other health needs can also help energy levels. If your clinician diagnoses a vitamin B12 deficiency, they may prescribe injections. See our option at Vitamin B12 Injection. Do not start or stop any therapy without clinical guidance.

Patient Suitability and Cost-Saving Tips

Mestinon SR® may suit patients who need longer coverage, nighttime control, or fewer daily doses. It may not suit those who cannot swallow tablets whole. People with severe asthma, slow heart rate, or bowel or urinary obstruction need medical review before use. Your clinician will decide the best fit.

To stretch your budget, consider a larger supply if your prescription allows. Multi-month packages can lower the cost per month and reduce shipping fees per dose. Set up reorder reminders in your account so you do not run out. For current offers and bulk options, see our Mestinon SR coupon page. Patients paying out of pocket can still achieve strong value, even when purchasing Mestinon SR® without insurance.

You can also browse related condition pages for practical support, such as Myasthenia Gravis and Fatigue. Our friendly customer-service chat is available during posted office hours if you need help placing an order or tracking a shipment.

Authoritative Sources

For detailed prescribing and safety information, consult official resources:

• Health Canada Drug Product Database
• FDA prescribing information via DailyMed: pyridostigmine bromide

YouDrugstore offers brand and generic medicines at Canadian prices with careful pharmacist review. Order online or by phone where available. We provide prompt, express, cold-chain shipping to the US, and support you at each step.

This content is for general information. It does not replace advice from your doctor, pharmacist, or other qualified professional. Always follow your own prescriber’s instructions and your local guidance.