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The side effects of Mestinonpyridostigmineare most commonly related to overdosage and generally are of two varietiesmuscarinic and nicotinicAmong those in the former group are nauseavomitingdiarrheaabdominal crampsincreased peristalsisincreased salivationincreased bronchial secretionsmiosis and diaphoresisNicotinic side effects are comprised chiefly of muscle crampsfasciculation and weaknessMuscarinic side effects can usually be counteracted by atropinebut for reasons shown in the preceding section the expedient is not without dangerAs with any compound containing the bromide radicala skin rash may be seen in an occasional patientSuch reactions usually subside promptly upon discontinuance of the medication.

Mestinonpyridostigmineis contraindicated in mechanical intestinal or urinary obstructionand particular caution should be used in its administration to patients with bronchial asthmaCare should be observed in the use of atropine for counteracting side effectsas discussed below.

The tablet forms of this medication may become discolored due to moistureThis does not affect how well the medication works.

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therefore, it is expected that mestinon will not be effective if administered just prior to or during exposure to soman.

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