An Investigation of the Metabolism of Neostigmine in Patients with Myasthenia Gravis

Abstract
Evidence of two metabolic products of neostigmine has been obtained by paper chromatography of urinary extracts from patients receiving the drug. One product has been identified as m‐hydroxyphenyltrimethylammonium bromide and the relevance of this is discussed in relation to the therapeutic effect of oral neostigmine in the treatment of myasthenia gravis. A method is described for extracting neostigmine and related compounds from urine by precipitation with bromine water.