Table 1.

Myasthenia Gravis Treatment with Cholinesterase Inhibitors – Options and Dosing

	Unit Dose	Average Dose (Adult)
Pyridostigmine bromide tablet (Mestinon)	60 mg tablet	30–60 mg every 4–6 h.
Pyridostigmine bromide syrup	12 mg/mL	30–60 mg every 4–6 h.
Pyridostigmine bromide timespan (Mestinon Timespan)	180 mg tablet	1 tablet twice daily
Pyridostigmine bromide (Parenteral)	5 mg/mL ampoules	1–2 mg every 3–4 h. (1/30 of oral dose)
Neostigmine bromide (Prostigmin)	15 mg tablet	7.5–15 mg every 3–4 h.
Neostigmine methylsulfate (Parenteral)	0.25–1.0 mg/mL	0.5 mg IM, IV, or SC ampoules every 2–3 h.
Children’s dosing:
Edrophonium
Diagnosis: 0.1 mg/kg IV (or 0.15 mg/kg IM or SC, which prolongs the effect), preceded by a test dose of 0.01 mg/kg
Pyridostigmine bromide (Mestinon)
Treatment: oral dose is about 1.0 mg/kg every 4–6 h, as tablets or syrup (60 mg/5 mL)
Neostigmine methylsulfate (Parenteral)
Neostigmine Diagnosis: 0.1 mg/kg/ IM or SC once or 0.05 mg/kg/ IV once
Neostigmine Treatment: 0.01–0.04 mg/kg/dose IM, IV, or SC q 2–3 h. p.r.n.