Mestinon (pyridostigmine bromide) is a brand-name drug that’s prescribed for myasthenia gravis. Mestinon comes as an oral tablet, extended-release oral tablet, and oral solution. The dosage can vary depending on the severity of the condition.

Mestinon belongs to a drug class called cholinesterase inhibitors. Mestinon is available in a generic version.

Keep reading for specific information about the dosage of Mestinon, including its forms and strengths and how to take the medication. For a comprehensive look at Mestinon, see this article.

Note: This article describes typical dosages for Mestinon provided by the drug’s manufacturer. When taking Mestinon, always follow the dosage prescribed by your doctor.

Below is information about Mestinon’s forms, strengths, and dosages.

Mestinon forms

Mestinon comes in the following forms:

  • oral tablet
  • oral solution
  • extended-release (ER) oral tablet, known as Mestinon Timespan

With ER medications, the drug is slowly released into your body over time.

Mestinon strengths

Mestinon oral tablets come in one strength: 60 milligrams (mg).

Mestinon ER oral tablets come in one strength: 180 mg.

Mestinon oral solution comes in one strength: 60 mg of active drug per 5-milliliter (mL) teaspoon of solution. For accurate dosing, a teaspoon is provided. It’s important to only measure your oral solution using this teaspoon.

Typical dosages

The following information describes dosages that are commonly prescribed or recommended in adults. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for myasthenia gravis

Doctors may prescribe Mestinon to treat myasthenia gravis.

If your doctor prescribes Mestinon for your myasthenia gravis, they will base your dosage on your symptoms. The following table shows typical dosages for each of the Mestinon forms. Always follow the dosage that your doctor recommends.

Mestinon formTypical dosageMaximum daily dosage
oral tablet600 mg (10 tablets), divided into doses taken multiple times per day25 60-mg tablets (1,500 mg)
extended-release (ER) oral tablet180–540 mg (1–3 ER tablets), taken once or twice per day 1,500 mg
oral solution10 tsp, divided into doses taken multiple times per day*25 tsp* (1,500 mg)

* One teaspoon (tsp) is equal to 5 milliliters (mL) of solution. For accuracy, it’s important to measure each dose of oral solution with the teaspoon provided.

In some cases, your doctor may prescribe the Mestinon oral tablets or solution in combination with Mestinon extended-release tablets. For more information about your specific dosage, talk with your doctor.

Long-term treatment

Mestinon is meant to be taken as a long-term treatment. If you and your doctor determine that Mestinon is safe and effective for you, you’ll likely take it long term.

Before you start taking Mestinon, your doctor will discuss your treatment plan with you.

The Mestinon dosage your doctor prescribes will depend on several factors. In some cases, your doctor may recommend a lower dosage of Mestinon, depending on:

  • your age
  • how your body responds to Mestinon
  • the severity of your myasthenia gravis
  • the form of Mestinon you take
  • other medications you take
  • side effects you may have with Mestinon
  • your kidney function

Other medical conditions you have can also affect your Mestinon dosage.

Mestinon comes as an oral tablet, extended-release (ER) oral tablet, and oral solution. You may take your dose with or without food. The manufacturer of Mestinon has not stated whether the tablets or extended-release tablets can be split, crushed, or chewed. If you have questions about this, talk with your pharmacist.

If your doctor prescribes Mestinon as an oral tablet or solution, you’ll typically divide your dose to take throughout the day. For example, for a total daily dose of 480 milligrams (mg), you might take:

  • two oral tablets (120 mg) every 6 hours, or
  • 2 teaspoons (10 milliliters) of solution every 6 hours

If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

If you have questions about how to use Mestinon, talk with your doctor or pharmacist.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you’re having trouble opening medication bottles, ask your pharmacist about putting Mestinon in an easy-open container. They also may recommend tools that can make it easier to open bottles.

If you miss a dose of Mestinon, talk with your doctor or pharmacist. The manufacturer of Mestinon has not provided recommendations on what to do if you miss a dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

It’s important that you do not take more Mestinon than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.

Effects of an overdose

Overdose effects of Mestinon can include:

If you take more than the recommended amount of Mestinon

Call your doctor right away if you believe you’ve taken too much Mestinon. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Mestinon.

What is the recommended maximum dosage of Mestinon?

For all forms of Mestinon, the maximum recommended dosage is 1,500 milligrams (mg) per day. However, your dosage may vary depending on your symptoms and what your doctor recommends. See the “Typical dosages” section above for more details.

If you have questions or concerns about your Mestinon dosage, talk with your doctor or pharmacist. If your current dosage isn’t effective for your condition, your doctor may increase your dosage. Do not adjust your dosage unless your doctor recommends doing so.

How long does it take for Mestinon to start working?

Mestinon starts to work after your first dose. During treatment, it’s important to track your symptoms and let your doctor know if the prescribed dosage is working for you. Your doctor will also likely monitor your condition to determine whether the drug is working appropriately.

Talk with your doctor if you have questions about what to expect with Mestinon treatment.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Mestinon for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Mestinon without your doctor’s recommendation. If you have questions about the dosage of Mestinon that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Mestinon. These additional articles might be helpful:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.