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Pyridostigmine Side Effects

The most commonly reported side effects of pyridostigmine include myasthenia gravis, off label use, and fatigue, based on 10,083 FDA adverse event reports from 2004 to 2025. 8.7% of reports found the drug to be ineffective.

Pyridostigmine side effects

Percentages show how often each reaction appears relative to total reports for pyridostigmine.

1
Myasthenia Gravis10.4%1,051
2
Off Label Use9.4%943
3
Drug Ineffective8.7%874
4
Fatigue8.0%804
5
Asthenia6.3%632
6
Diarrhoea5.9%596
7
Headache5.5%553
8
Dyspnoea5.4%543
9
Nausea4.9%497
10
Fall4.1%412
11
Muscular Weakness4.1%409
12
Dizziness3.7%371
13
Condition Aggravated3.4%347
14
Pain3.2%319
15
Malaise3.1%314

These are voluntary reports and do not establish that pyridostigmine caused these reactions.

Report severity

73.2%Serious7,377 reports
35.6%Hospitalizations3,594 reports
7.8%Fatal787 reports

Seriousness is determined by the reporter, not by OpenClaim.

Pyridostigmine drug interactions

Other drugs that appear in adverse event reports alongside pyridostigmine. Drugs flagged as a suspected cause appear in the first column. Drugs taken at the same time but not suspected appear in the second.

Also suspected

1
Amifampridine9.2%924
2
Prednisone7.3%741
3
Eculizumab6.0%601
4
Mycophenolate5.4%542
5
Efgartigimod4.9%490
6
Ravulizumab-cwvz4.6%468
7
Rituximab3.9%394
8
Azathioprine3.8%387
9
Prednisolone3.7%374
10
Droxidopa2.7%277
11
Sodium-oxybate2.6%258
12
Zilucoplan-sodium2.3%229
13
Methylprednisolone2.1%208
14
Tacrolimus1.6%159
15
Rozanolixizumab-noli1.2%116

Taken alongside

1
Prednisone22.7%2,291
2
Ergocalciferol14.7%1,486
3
Acetaminophen13.9%1,403
4
Levothyroxine-sodium11.5%1,155
5
Aspirin11.3%1,139
6
Omeprazole9.3%938
7
Albuterol8.4%849
8
Gabapentin7.6%762
9
Atorvastatin-calcium7.5%753
10
Pantoprazole-sodium7.4%751
11
Azathioprine7.3%734
12
Diphenhydramine6.9%698
13
Ondansetron6.5%651
14
Fluticasone6.3%637
15
Furosemide6.3%633

Co-occurrence in adverse event reports does not establish a drug interaction. Patients often take multiple medications, and these lists reflect prescribing patterns rather than causal relationships. Consult a healthcare provider about potential drug interactions.

Who reports pyridostigmine side effects

52.7% of pyridostigmine adverse event reports involve female patients and 36.1% involve male patients. The largest age group is adult at 50%. These figures reflect who reports side effects, not underlying risk.

Sex

Female52.7%
Male36.1%
Unknown11.2%

Age group

< 20.9%
2–111.0%
12–171.4%
18–6449.9%
65+46.8%

What is pyridostigmine used for

Conditions and purposes for which patients were taking pyridostigmine when the adverse event was reported.

3m SyndromeAbdominal DiscomfortAbdominal DistensionAbdominal PainAdrenal InsufficiencyAmblyopiaAmyotrophic Lateral SclerosisAnaesthesia ReversalAngiopathyAntiacetylcholine Receptor Antibody PositiveAstheniaAtrial FibrillationAutoimmune DisorderAutonomic Failure SyndromeAutonomic Nervous System Imbalance

Showing 15 of 294 indications

Pyridostigmine brand names and reporting trend

Pyridostigmine is sold under the brand name Regonol.

Brand names

Regonol5,861

Quarterly reports (20042025)

20052010201520202025

An upward trend reflects increased FAERS reporting overall, not necessarily increased risk.

Taking pyridostigmine with another medication?

Ask OpenClaim about your specific drug combination. Get a sourced report using FDA data, drug labels, and medical literature.