INTRODUCTION

GRAVITOR SR 180MG contains Pyridostigmine which belongs to the group of medicines called Anticholinesterases. It is used to manage myasthenia gravis and paralytic ileus (paralysis of digestive tract muscles). It can also be used to manage urinary retention after surgery (inability to urinate due to an anaesthetic or certain types of surgery). Myasthenia gravis is an immune system disease which prevents messages from the brain from reaching the muscles, causing muscles to become tired and weak, in severe cases it causes muscles to be paralyzed.

Pyridostigmine works by preventing the breakdown of a chemical called acetylcholine, which is required to stimulate muscle movement by improving the communication between nerves and muscles.

Do not take GRAVITOR SR 180MG if your digestive or urinary tract is obstructed. Before taking GRAVITOR SR 180MG, inform your doctor if you have kidney, heart, or thyroid problems, stomach ulcer, fits, or parkinson’s disease. GRAVITOR SR 180MG should be used in pregnant women only if considered necessary by your doctor. GRAVITOR SR 180MG should be used with caution among breastfeeding women, therefore consult your doctor before taking it. Your doctor will prescribe the right dose of GRAVITOR SR 180MG for your child depending on age, body weight and health condition. The most common side effects of taking GRAVITOR SR 180MG are nausea, vomiting, diarrhea, stomach cramps or pains, increased saliva, chest tightness, low blood pressure, muscle cramps and twitching. Contact your doctor if any of the symptoms worsen.

USES OF GRAVITOR SR 180MG

Used to manage:

• myasthenia gravis
• paralytic ileus
• urinary retention after surgery

HOW GRAVITOR SR 180MG WORKS

GRAVITOR SR 180MG works by preventing the breakdown of a chemical called acetylcholine, which is required to stimulate muscle movement by improving the communication between nerves and muscles.

DIRECTIONS FOR USE

Take GRAVITOR SR 180MG as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop taking GRAVITOR SR 180MG unless your doctor advises you to stop.

SIDE EFFECTS OF GRAVITOR SR 180MG

HOW TO MANAGE SIDE EFFECTS

Nausea:

Stick to simple meals. Avoid eating oily or spicy foods. If nausea does not improve, contact your doctor.

Vomiting:

Get adequate rest. Drink sufficient fluids, especially water. Have small sips if you feel sick. Eat when you feel hungry or when to like to eat, in smaller quantities. Avoid eating oily or fried foods. Do not take any medicine for vomiting without asking your doctor. If vomiting does not improve, contact your doctor.

Diarrhea:

Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not take any medicine on your own to manage diarrhea without consulting your doctor. If diarrhea does not improve, contact your doctor.

Stomach pain:

Try to rest and relax. Eat and drink slowly or try to have smaller meals more frequently. Keep a heat pad on your stomach. If the stomach pain does not improve, contact your doctor.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug - Drug interactions:

Before taking GRAVITOR SR 180MG, inform your doctor if you are taking any of the following medicines: 

• medicines used to manage vomiting or diarrhoea (Ex. atropine, hyoscine)
• medicines used to relax muscles during surgery (Ex. pancuronium, vecuronium, suxamethonium)
• methylcellulose (used to manage constipation)
• medicines used to manage bacterial infections (Ex. amikacin, gentamicin)
• medicines used to manage irregular heartbeat (Ex. quinidine, amiodarone)
• medicines used to manage inflammatory conditions (Ex. prednisolone, beclomethasone)
• medicines used after organ transplant to prevent rejection (Ex. cyclosporin, tacrolimus)

Overdosage:

If you or anyone else accidentally take too much of GRAVITOR SR 180MG, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are muscle or stomach cramps, diarrhea, nausea, vomiting, increased saliva, pin-point pupils of the eyes, sweating, muscle twitching, weakness and slow heartbeat.

SYNOPSIS

MORE INFORMATION

• Keep GRAVITOR SR 180MG out of reach of children
• Store below 25°C

FAQs ABOUT GRAVITOR SR 180MG

Can GRAVITOR SR 180MG be taken during pregnancy?

GRAVITOR SR 180MG should be used in pregnancy only if considered necessary by your doctor. If you are pregnant, think you may be pregnant or planning to get pregnant, consult your doctor before taking this medicine. Inform your doctor immediately if you become pregnant during management with GRAVITOR SR 180MG.

What is the best time to take GRAVITOR SR 180MG?

Take GRAVITOR SR 180MG as advised by your physician. Swallow the medicine with a glass of water. GRAVITOR SR 180MG is usually taken during the day when maximum strength is required, for example, after getting up and 30 to 60 minutes before having a meal. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

Can I take GRAVITOR SR 180MG if I am constipated?

GRAVITOR SR 180MG is not recommended for use in patients having constipation or an obstructed digestive tract unless your doctor finds it necessary. Consult your doctor before taking it.

Can GRAVITOR SR 180MG be given to elderly patients?

GRAVITOR SR 180MG should be used with caution in elderly patients (aged above 65 years) with irregular heartbeat or other heart condition. Consult your doctor before taking it.

Can I take other medicines with GRAVITOR SR 180MG?

Before taking GRAVITOR SR 180MG, inform your doctor if you are taking, have taken, or might take any other medicine, including prescription, non-prescription or any herbal medicine. This is important because taking multiple medicines at a time can strengthen or weaken the effect of the medicines.

Can I drive a car after taking GRAVITOR SR 180MG?

Do not drive a car or use machinery during GRAVITOR SR 180MG management unless you are sure that your judgement and coordination is not affected, as the effects of this medicine on driving ability is not yet established. Consult your doctor if you feel any side effect during management with GRAVITOR SR 180MG that may stop you from driving or using machines.

What if I forget to take a dose of GRAVITOR SR 180MG?

If you forget to take a dose of GRAVITOR SR 180MG, take it as soon as you remember. However, omit the missed dose if it is almost time for the next dose. Do not take the medicine twice to make up for a forgotten dose.

Can I stop taking GRAVITOR SR 180MG on my own?

Continue taking GRAVITOR SR 180MG until your doctor tells you to stop, unless you experience any unwanted effects, worsening of your condition or any new symptoms. In such case, contact your doctor right away.

Can GRAVITOR SR 180MG cause vomiting?

Vomiting is a common side effect of GRAVITOR SR 180MG. In such case, get adequate rest and drink sufficient fluids, especially water. Have small sips if you feel sick. Eat when you feel hungry or when to like to eat, in smaller quantities. Avoid eating oily or fried foods. Do not take any medicine for vomiting without asking your doctor. Tell your doctor if you have continuous vomiting.

What precautions do I need to follow while taking GRAVITOR SR 180MG?

Patients taking GRAVITOR SR 180MG must inform their doctor about their pre-existing disease conditions like obstructed digestive or urinary tract, kidney, heart, or thyroid problems, stomach ulcer, fits or parkinson’s disease. Patients should also inform if they are pregnant, breast-feeding or having any allergies. Contact your doctor immediately if you have any unusual symptoms.

REFERENCES

1. Tilo Grosser, Emer Smyth and Garret A. FitzGerald. Anticholinergic Agents. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 213.

2. Maggi, L., & Mantegazza, R. Management of myasthenia gravis. SpringerLink. August 2012. [Accessed on 2nd July 2022] https://link.springer.com/article/10.2165/11593300-000000000-00000

3. University of Aarhus. Effect of Pyridostigmine (Mestonin) on Muscle Strength in myasthenia Gravis. NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised in April 2018] [Accessed on 2nd July 2022] https://clinicaltrials.gov/ct2/show/NCT03510546

4. Labiana Pharmaceuticals S.L.U. Health Products Regulatory Authority (HPRA). [Revised in December 2019] [Accessed on 2nd July 2022] http://www.hpra.ie/img/uploaded/swedocuments/8f7764b6-2c82-4549-a422-d6f5b3a65819.pdf

5. Actavis Group PTC ehf. Pyridostigmine. [Revised in March 2022] [Accessed on 2nd July 2022] https://products.tevauk.com/mediafile/id/52098.pdf

6. Bausch Health Companies Inc. Pyridostigmine. [Revised in December 2020] [Accessed on 2nd July 2022] https://pi.bauschhealth.com/globalassets/BHC/PI/Mestinon-PI.pdf

7. iNova Pharmaceuticals (Australia) Pty Limited. Pyridostigmine. [Revised in March 2021] [Accessed on 2nd July 2022] https://www.nps.org.au/assets/medicines/3b41b44e-e983-4793-8d1e-a53300ff254a.pdf

USEFUL DIAGNOSTIC TESTS

• Edrophonium test
• Electromyography (EMG)
• CT-scan
• MRI Scan