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Pyridostigmine

Prescription
Acetylcholinesterase Inhibitor / Anticholinesterase
Last reviewed 21 Apr 2026 · PetCare.AI Editorial Team
Species
Dog, Cat
Brands
2 available
Formulations
4

Mechanism of action

Reversibly inhibits acetylcholinesterase at the neuromuscular junction, allowing acetylcholine to accumulate and bind nicotinic receptors on skeletal muscle, improving neuromuscular transmission. Used for myasthenia gravis management.

At a glance

Class
Acetylcholinesterase Inhibitor / Anticholinesterase
Schedule
Prescription
Storage
Store at room temperature below 25°C, protect from moisture; injectable refrigerated

Dosing

🐕

Dog

Treatment of choice for generalized and focal myasthenia gravis in dogs
Dose
0.5–3 mg/kg
Route
PO
Frequency
q8–12h (IR) or q12h (SR)
🐈

Cat

Feline myasthenia gravis is less common but documented
Dose
0.25 mg/kg
Route
PO
Frequency
q8–12h

Formulations

💊

Other — 4

Strength
Strength
Strength
Strength

Storage

Store at room temperature below 25°C, protect from moisture; injectable refrigerated

Safety

Monitoring parameters

Muscle strength (response to Tensilon test if in crisis)Signs of cholinergic toxicity vs. myasthenic weaknessChest radiograph (aspiration pneumonia risk)

Interactions

No documented interactions.

Brands

Other markets

Mestinon
Regonol

FAQs

Frequently asked questions

What is Pyridostigmine?
Pyridostigmine is a acetylcholinesterase inhibitor / anticholinesterase used in pets. Reversibly inhibits acetylcholinesterase at the neuromuscular junction, allowing acetylcholine to accumulate and bind nicotinic receptors on skeletal muscle, improving neuromuscular transmission. Used for myasthenia gravis management.
What is Pyridostigmine used for in pets?
Pyridostigmine is used in veterinary medicine for: Treatment of choice for generalized and focal myasthenia gravis in dogs; Feline myasthenia gravis is less common but documented.
What is the Pyridostigmine dose for dogs?
For dogs, Pyridostigmine is typically dosed as follows — Treatment of choice for generalized and focal myasthenia gravis in dogs: 0.5–3 mg/kg PO q8–12h (IR) or q12h (SR). Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
What is the Pyridostigmine dose for cats?
For cats, Pyridostigmine is typically dosed as follows — Feline myasthenia gravis is less common but documented: 0.25 mg/kg PO q8–12h. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.
Does Pyridostigmine need a prescription?
Yes. Pyridostigmine is a prescription medication and should only be administered under veterinary supervision.

References

References

Textbooks & handbooks

  • Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
  • Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
  • Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
  • National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
  • The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

  • Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
  • American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

  • Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
  • Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
  • ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

  • Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

  • Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/
Educational reference only
This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →