Clinical pharmacology of pyridostigmine and neostigmine in patients with myasthenia gravis.

Publisher Website
Google Scholar
Abstract
Determination of plasma concentration of pyridostigmine in 20 myasthenic patients on [cholinesterase inhibitor] maintenance therapy revealed rather small intraindividual variations within a dose interval. The predose concentration varied considerably between different patients and up to 7-fold in patients on the same daily dose. No pharmacokinetic interaction between pyridostigmine and neostigmine occurred in 5 patients studied. In 6 patients the decrement in the deltoid muscle was studied in parallel with determination of the plasma concentrations following administration of pyridostigmine or neostigmine. In these patients the existence of a bell-shaped dose response curve is suggested with the maximal effect at a concentration of 30-60 ng/ml for pyridostigmine and 5-15 ng/ml for neostigmine.