Reply To: Pyridostigmine Side effect or allergic reaction?

[Community Member]

So sorry to hear of your negative reaction to Pyridostigmine.  I have had gMG for over six years.  For the first four years I was taking 60mg Pyridostigmine @  3 to 4 per day.  The nighttime leg cramps were horrible.  I modified my medication to 2 Pyridostigmine per day (morning and noon), and 500mg Mycophenolate @  1 per day (5:00pm).  The leg cramps disappeared.  Why?  When I am resting or sleeping and there is too much Pyridostigmine in my system, that enables too much acetylcholine to penetrate muscle receptors and cause certain muscles to contract involuntarily.  This bypasses the intricate brain, nerve, acetylcholine balance so the muscles get a flood of messages to contract, but do not get corresponding messages to relax.  Bummer!!  I buy these meds via goodrx.com for the best prices.  I hope that this info is helpful.