Mestinon 60mg 1 Tablet
| Generic Name | Pyridostigmine Bromide |
| Strength | Amber Bottle x 150's Box of 1's |
| Indication/Usage | treatment of myasthenia gravis. |
| Dosage and Administration | When using Mestinon"', it is important to remember that the full effect appears gradually, usually within 15-30 minutes. Use in Adult 1-3 Dragees (60-180mg) 2-4 times daily, or higher doses it required. T~e total daily dose is usually in the range of 5.-20 Dragees (300mg - 1200mg) but doses hlqher than these may be needed by some patients Use in Children Children under 6 years old should receive an initial dose of 30mg of Mestlncn". Children 6 - 12 years old should receive 60mg. Dosage should increase gradually, .in Increments of 15 - 30mg dally, until maximum Improvement IS obtained. Total dally requirements are usually in the range to 30 - 360mg. Patients with swallowing difficulties can take tablets broken into small pieces instead of the whole tahlets or Dragees. In Myasthenia gralJls, one dose is effective for approximately four hours during the day \'vtlilst at night (owlflgto reduced physical activity), a longer duration of effect of around 6 hours can be expected. It is recommended that tile times of administration be chosen so that the maximum effect ccncdes with the most strenuous physical exertion, e.g.lNhen getting up and at mealtimes. Speast dosage instructiOI1S The required dose must be carefully titrated when used in paediatrics. In cases of neonatal myasthenia, generally one treatment with neostigmine (Prostigmine) IS preferred. However, it this appears unsuitable due to excessively cholinergic side effects, then Mestinoo'" can be administered. In these cases, the following serves as a rough guideline 5-10mg by mouth in tablet form, 30-60 minutes before food. Treatment over the eighth week of lite is required only in extremely rare cases of congenital and familial illfantile myasmerua. |
| Warning and Precautions | Mestinon' is contraindicated in mechanical obstruction of the intestinal or urinary tract and known allergy to the preparation. Pvndostiqmme is mainly excreted unchanqed by the kidney. Therefore, lower doses may be reqUired In patients With renal disease, and treatment should be based on titration. of drug dosage to effect. Although failure of patients to show. clin cal improve.ment may reflect under dosage, i.t can atso be incicative of ov~rdos~ge. As IS true 01 allcholinerqc dru.gs, overdosage of Mesllfl?"~ may result In cholinerqlc cnSIS, a state charactensed by mcreasmq muscle weaknes~ I'JhIC~, through in~olveme~t of the muscles 01 respiration. may lead to death. MyastheniC crisis due to an mcrease m the seventy of the disease is also accompanied by extreme muscle weakness, and thus may be difficult to distinguish from cholinergic crisis on a symptomatic basis. Such differentiation is extremely important, since increases in doses of Mestlnon~ or other drugs of this class lnthe presence 01 cholinergic crisis 0 r ot n re'ractcrv or "insensitive" state could have a qrave consequence. The different diagnosis ?f.the two types of crisis may require the use of Tensilon (edrophonium chloride) as well as clinical Judgment. The treatment of the two conditions obviously differs radically. WIlereas the presence of myasthenic crisis suggestslhe need 101 more intensive anti-cholinesterase therapy, the diagno~is of cholinergi~ crisis, cal.ls for. the prompt withdrawal of all drugs of this type. The immediate use of atropine In cholinergic crisis is also recommended . Atropine may abolish Of obtund gastrointestinal side effects or other muscarinic reactions; but such use, by masking the signs of overdosage, can lead to inadvertent induction of chclinergc crists. |
| Adverse Reactions | like all cholinergic drugs, Mestinon~ can have undearade nnc'ional effects on the autooomic nervous system. Muscarine-type side effects can manifest themselves as nausea, vomiting, diarrhoea, stomach cramps, increased peristalsis and bronchial secretion, salivation and lacrimation as well as bradycardia and miosis. Nicotine-type side effects consist mainly of muscle spasms; muscle twitches and muscle weakness. like other bromine-containing drugs, Meslinon: can occasionally cause skin rash, althoeqh this generally disappears. rapidly o~ce medication has heen discontinued. Further use of Mestinon~ or other bromine-containing preparations is then contra-Indicated. |
| Contraindication | Mestinon' is contraindicated in mechanical obstruction of the intestinal or urinary tract and known allergy to the preparation. Pvndostiqmme is mainly excreted unchanqed by the kidney. Therefore, lower doses may be reqUired In patients With renal disease, and treatment should be based on titration. of drug dosage to effect. |
| Drug Interaction | Pyridostigmine antagonises the action of curare-like non-dcpolansinq muscle relaxants. Atropine counteracts the cholinergic effects of pyridostigmine. |
| Requires Prescription? (Yes or No) | Yes |
| Overdose and Treatment | Overdosage with Mestlnon" or other cholinesterase inhibitors can lead to cholinergic crises that mantest themsetves in, among other things, pronounced muscle weakness (or exacerbated muscle weakness in patients with myasthenia). If such a situation is overlooked, llte is endangered due to paralysis of the respiratory muscles. Bradycardia and - pal a.doxically, tachycardia are other posslele ettects. Countermeasures include the Immediate Withdrawal of Mestlnoo.!- or other cholinerglcs and the slow Intravenous administration of 1-2mg atropine sulphate. Depending on the pulse rate, this dose is to be repeated at intervals 01 two to four hours If required. |
| Storage Conditions | Store at temperatures not exceeding 30ºC |
1. We will deliver orders in the following areas (except in island barangays).
| a) Pangasinan ✔ Dagupan City |
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| b) La Union ✔ Agoo |
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| c) Ilocos Sur ✔ Tagudin |
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| d) Ilocos Norte ✔ Laoag City |
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| e) Bataan ✔ Orion |
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| f) Abra ✔ Bangued |
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| g) Pampanga ✔ Angeles City |
2. There are two (2) ways to receive your order:
a) via Home Delivery
b) via Store Pickup in any of the following St. Joseph Drug (pick-up point)i> branches:
✔ Perez Blvd., Dagupan City
✔ Mabini St., Poblacion West, Calasiao, Pangasinan
✔ Rizal St. corner Biagtan St., Poblacion, Mangaldan, Pangasinan
✔ Rizal St., Poblacion, San Fabian, Pangasinan
✔ Charms Bldg., Poblacion, Pozzorubio, Pangasinan
✔ CB Mall, Mc Arthur Highway, Nancayasan, Urdaneta, Pangasinan
✔ Zone 1 Market Road corner McArthur Highway, Villasis, Pangasinan
✔ Roxas corner Malong St., San Carlos, Pangasinan
✔ Calvo St., Mangatarem, Pangasinan
✔ Poblacion, Basista, Pangasinan
✔ Poblacion, Binmaley, Pangasinan
✔ Solis St., Brgy. Poblacion, Lingayen, Pangasinan
✔ Poblacion, Quezon Avenue, Alaminos, Pangasinan
✔ Concordia (Pob.), Bolinao, Pangasinan
✔ National Road, Poblacion, Bani, Pangasinan
✔ Mother Goose Bldg., Tapuac District, Dagupan City, Pangasinan
✔ Joleco Bldg., I, A.B. Fernandez Ave., Dagupan City, Pangasinan
✔ E&J Bldg., Milo Street, Manaoag, Pangasinan
✔ Panda Ave., Poblacion, Mapandan, Pangasinan
✔ San Guillermo, San Jacinto, Pangasinan
✔ Blue Horizon Bldg., Quezon Blvd., Poblacion, Alaminos City, Pangasinan
✔ CentroMart, Rizal St., Lingayen, Pangasinan
✔ Poblacion, Aguilar, Pangasinan
✔ Romulo Highway, Poblacion, Bugallon ,Pangasinan
✔ Gen. Luna St., Poblacion, Rosales, Pangasinan
✔ Quezon Blvd., Tayug, Pangasinan
✔ National Road, Umingan, Pangasinan
✔ Poblacion East, Alcala, Pangasinan
✔ M.H. Del Pilar St., Bayambang, Pangasinan
✔ CSI, Malasiqui, Pangasinan
✔ P. Tavera St., Poblacion, Binalonan, Pangasinan
✔ Guiset Sur, San Manuel, Pangasinan
✔ Poblacion West, Asingan, Pangasinan
✔ G/F Magic Mall, Alexander St., Urdaneta City, Pangasinan
✔ Poblacion, Infanta, Pangasinan
✔ Agbayani St., Poblacion, Sual, Pangasinan
✔ Poblacion, Urbiztondo, Pangasinan
✔ Poblacion, Sta.Barbara, Pangasinan
✔ Victoria Rd., San Nicolas Norte, Agoo, La Union
✔ CSI City Mall, Biday, San Fernando City, La Union
✔ Osmeña Street, San Fernando City, La Union
✔ Poblacion East, Rosario, La Union
✔ Brgy. Lacong, Tagudin, Ilocos Sur
✔ Hennady Bldg. McArthur Poblacion, Brgy. V, Bantay, Ilocos Sur
✔ National Highway, San Antonio, Candon City, Ilocos Sur
✔ Quezon Avenue, Vigan City, Ilocos Sur
✔ City Galore Square, J.P. Rizal cor. Ligo St., Laoag City, Ilocos Norte
✔ Trece Grande Bldg., 187 JP Rizal St. Cor. Dr. Damaso Samonte St. Brgy 19, Laoag City, Ilocos Norte
✔ National Road, San Vicente, Orion, Bataan
✔ Taft St., Zone 5, Bangued, Abra
✔ Washington St., Brgy 2 Abian, Batac, Ilocos Norte
✔ Middle Session, Baguio City, Benguet
✔ G/F Senvik Loy Bldg., La Trinindad, Benguet
✔ CSI Warehouse, Purok I Palanginan, Iba, Zambales
✔ Magic Mall, Poblacion, Sta. Cruz, Zambales
✔ Sto. Rosario St., Sto. Domingo, Angeles City, Pampanga
3. We charge the following delivery fee:
| Mode of Delivery | Delivery Fee |
|---|---|
| Home Delivery | Delivery fee starts at P60.00 for the first four (4) kilometers. Additional amount will be charged depending on the distance of the shipping address you specified (please refer to the Shipping Fee Directory). |
| Store Pickup | Free of Charge |
4. We will deliver your order as follows:
a) for Home Delivery
| Orders Received | Delivery Schedule |
|---|---|
| Before 1:00pm | Same day delivery within 2:00pm to 6:00pm |
| After 1:00pm | Next day delivery within 2:00pm to 6:00pm |
b) for Store Pick-up
You may expect your order to be ready within 2 hours to a day (depending on the availability of ordered item) upon placement of order. You will be notified via call/SMS once your order is ready for pick-up. We encourage you to claim your order within 3 days (during store hours) upon receipt of advice that your order is ready for pick-up, otherwise, such shall deemed as cancelled.
5. We will deliver your order from Monday to Sunday (including holidays) from 2:00pm to 6:00pm.
6. There are two (2) ways to track your order:
a) For every change in the order status, an email will be sent to you.
b) You can also check your order status by signing-in to your account. Just go to “My Account” and click “Orders” to display the order status.
7. In case you are not home when your order arrives, you may have a representative receive and pay the package for you. However, if payment was made via bank transfer, your representative shall be required to present the following:
a) Authorization Letter; and
b) Your Valid ID (with picture and signature) and that of your representative.
8. If nobody is available to receive your order, our Rider will bring your package back to St. Joseph Drug pick-up point branch nearest/ covering the shipping address you specified, for pick-up within the 3-day claiming period or you can have it redelivered but with a corresponding redelivery fee.
ITEM RETURN/ EXCHANGE/ REFUND1. All products ordered from St. Joseph Drug are subject to quality checking by our designated personnel prior to delivery to/ pick-up by customers.
a) Upon delivery to / pick-up by customer:
✔ Please inspect your package in the presence of our Rider/Pharmacy Assistant. Your signature on the Acknowledgement Receipt signifies that you have received the products completely, correctly, and in good condition (not damaged / defective and / or expiring / expired).
✔ You may refuse to accept the product if such is incorrect, incomplete, or not in good condition. For home delivery, we will redeliver the replacement or additional item/quantity free of delivery charge.
b) After delivery to / pick-up by customer:
✔ We will still accommodate request for item return / exchange / refund under the following conditions:
- Promptly returned within 7 days upon receipt of the product
- Duly supported by St. Joseph Drug official receipt
Note : We may require additional documents (e.g. photo of the affected product) to support your request.
✔ The following items will be acceptable:
- items in good condition provided such are:
- not in a vial
- not loose tablets/capsules
Note : The product must be in its original box/packaging (unused) and complete with gift/promo item (if any).
- products with explicit manufacturing defect
Note : Damaged / defective items due to customer's mishandling or improper use will not be accepted.
✔ Once your request is approved, we will redeliver the replacement or additional item/quantity but with a corresponding redelivery fee (except for products with explicit manufacturing defect which we will redeliver free of delivery charge).
✔ Requests for refund will be reviewed and handled on a case-by-case basis and subject to management's approval.
2. To request for item return/ exchange/ refund, perform any of the following:
a) contact 0917-565-3700 or 0998-530-3700; or
b) report via our live chat/ messaging; or
c) proceed to St. Joseph Drug Perez Blvd., Dagupan City branch.
Note : Request for return/ exchange/ refund of items ordered via our Online Store will not be accepted in any other St. Joseph Drug branches.
3. Requests for item return/ exchange/ refund will be processed within 2-3 working days upon receipt of the required supporting documents. You shall be notified via call/ SMS once the request has been approved.
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