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I kind of had the same problem with this drug except I was itching all over when I took pyridostigmine. My neuro suggested that it was an additive of the medication that I was reacting to and not a true allergy to the main ingredient. He suggested I search for another pharmacy that uses a different manufacturer of pyridostigmine. So I was using Walgreens and I found that Rite aid used a different manufacturer for their pyridostigmine which ended up solving the problem. No itching. It was a huge relief because the drug works really well for me. I hope this helps. Good luck