• Mestinon shortage

    Posted by Charles Karcher on March 27, 2024 at 1:51 pm

    Just picked up a 30 day supply of Pyridostigmine Bromide 180 ER. The pharmacy could not fufill a 180 day order as there seems to be a nationwide shortage. They said that the warehouse had no supply and no idea when more would arrive. I checked with another pharmacy and was told the same thing. They also checked the FDA website where manufacturers are supposed to report shortages and there was no information. I last filled on 12/07 and had no issues. Anyone faced the same issue? Any information on what the current situation? What is the alternative to 180 ER?

    Darrylc replied 4 days, 18 hours ago 22 Members · 25 Replies
  • 25 Replies
  • Keith Wilson

    March 27, 2024 at 2:32 pm

    Try Pricepropharmacy.com

    Online ordering from Canada turkey UK etc.

  • TaylorZimmet

    March 27, 2024 at 2:36 pm

    Hi Charles,

    I recently picked up my mestinon 60mg pills and didn’t have an issue. Have you tried the 60mg tablets? Since the 60mg are immediate release, I believe that they release at the same rate as the 180 mg ER pills. But the 60 mg dose may work differently for you compared to the 180 mg ER.

    I’m not a doctor, so your doctor should know more about the differences between these doses.

    Hope this helps 🙂

  • MikeS

    March 27, 2024 at 2:41 pm

    I did a cursory search on Google and it seems, at first glance, that this shortage happened primarily in Australia starting January, 2023, with spot shortages in Canada and Great Britain. If anyone has current information on this issue, especially if occurring in the U.S., please reply and include any relevant link(s). I live in California and use Pyridostigmine, and there’s been no problem with supply here.

  • TaylorZimmet

    March 27, 2024 at 2:45 pm

    One more thing I’d like to add.

    When I was in the hospital two years ago, I was accidentally given three 60 mg instead of one 180 mg ER. I learned the hard way that it was too much medicine.

  • mary-s-browder

    March 27, 2024 at 3:21 pm

    Filled mine a month ago (60mg) tablets with no problem.

  • Omi

    March 27, 2024 at 3:34 pm

    I couldn’t get my full refill either of Pyridostigmine 60 mg. I had to beg the pharmacist to give me what she had available.

  • Mama

    March 27, 2024 at 3:35 pm

    Each time I go to pick up my refill, they do not have enough and tell me to come back the next day. So far, I still am able to get it. I have been concerned because there is an issue with some medications. Pyridostigmine is the only thing I have used since my diagnosis in August if 2023. It works well for me. This is something to keep our eyes on.

  • zeke

    March 27, 2024 at 10:10 pm

    There appears to be a shortage of the 180 mg dose of Pyridostigmine. This is a time-release medication. I take it at night so I can function first thing in the morning . I tried for a week to refill for 90 days and was continually told that the warehouse did not have any and they did not know when more would be coming in. The pharmacy checked 4 other locations which showed to have a supply. The first pharmacy I called told me they did not have any at all regardless of what the computer was showing. Two of the remaining pharmacies were in the city of Chicago which were 30 to 40 miles away. The last one I called was 20 miles away in a southern suburb. They stated they could fill my entire order. I was very lucky. Please start your refill search as early as possible. DO NOT TAKE 3 60 MG OF THIS MEDICATION. IT IS NOT EQUIVALENT. Good luck to all of us in search of the correct meds that we need to try and lead a normal life!!

    • standia

      April 3, 2024 at 2:20 pm

      It is important to understand that the 180 MG capsule is an ER (extended Release) medication gradually released to your body at a controlled rate over the 24 hours till the next dose. The 60 mg tablet is usually taken one every 6 hours, so taking 3 60mg tablets at the same time is probably a significant overdose. Be careful and consult you doctor any time you are in doubt about dosage and timing.


      • Andy Coyne

        April 3, 2024 at 2:50 pm

        I take 2x60mg 4 times a day and have taken 3x60mg with no adverse effects at all. However you should never take more than your prescribed dose.

    • Bon

      April 9, 2024 at 2:02 pm

      Same for me. I can’t get my prescription filled and I can’t afford the name brand Mestinon. It’s 2700 dollars.

  • MelissaF

    March 28, 2024 at 12:47 pm

    PA, USA here. Same problem. My Timespan 180mg tablets have been on back order since March 15th. I spoke to the pharmacy again as I had hit the point where I was out of prescription. It is delayed at the manufacturer, no idea when it will be available. Checked with a few other pharmacies in my area, same story. Checked with the local hospital pharmacy, she could not even order it, it just came up as “Out of Stock” for the 180 and the 60mg tablets as well. After much calling around, I found 1 pharmacy with a 30 day supply they could fill to tide me over. I did have to jump through a few hoops to get the prescription transferred, and find someone to pick it up for me since without Mestinon on board I was not up to driving or walking anywhere. I contacted the Myasthenia Gravis Foundation to let them know there was a manufacturing issue with a medication so many of us depend on. They returned my call immediately to let me know that the there are shortages in Europe & the Australian but currently the FDA did not have it listed as an issue in the US, so they were going to look into it more.

  • MelissaF

    March 28, 2024 at 12:54 pm

    Forgot to add…you can go to the FDA Drug Shortage website and report any shortages. I reported mine, if you have trouble in your area, I would report it there as well.

  • James McCay

    March 29, 2024 at 12:03 pm

    It’s very possible this was caused by games Big Pharma plays since Gov’t payments for medications have decreased; quite drastically in the US since 2010.

    I’ve had problems getting common medications filled in NYC at least once every 3-months on average. Also many pharmacies charge your Medicare/Medicaid for expensive prescriptions you never receive, how many actually read your Monthly MEDICARE payment reviews? I can’t even read mine due to my MG blurry vision & being all alone.


  • Stanley Martin

    March 29, 2024 at 9:45 pm

    No problem I just received a 90 day supply today in Baton Rouge at Walmart of pyridostigmine

  • MJK

    March 30, 2024 at 12:17 pm

    Just received my 90 day supply from a mail order pharmacy. The manufacturer is Rising, which is different than the one they sent in the past. The previous one was Alvogen.

  • jeri castellanos

    April 10, 2024 at 2:24 pm

    I was supposed to get a 30 day supply of Pyridostigmine 180 ER on March 4 and was told the same thing. I wasnt able to fill it until March 20th. I saw my neurologist in the interim and all he said was that i would have to switch to 60mg tabs if i needed to get it right then. Unfortunately the 60 mg doesnt work for me.

  • Charles Karcher

    April 10, 2024 at 2:35 pm

    I checked two days ago and none was available. The pharmacy said next check date would be mid-April. I have about 30 day supply on hand. The supplier the pharmacy uses is in India.

  • Lou DeYenno

    April 10, 2024 at 4:17 pm

    I am on a auto-refill program with my prescription provider and was told there was a delay with my 180mg long acting pyridostigmine. I was down to a weeks supply and called my provider for assistance. They called various (4) pharmacies for me until they found a resource that had 180mg in stock. I was able to get a 90 day supply but I think that was the last at that location. It appears that the 60mg tablet is readily available but that dosage causes more side effects for me.

  • Woodworker

    April 12, 2024 at 11:16 am

    I find no shortage of Mestinon as I just got an order of a 90-day supply of the 180 mg. SR tablets and a 90-day supply taken twice daily of the 60 mg. tablets, but I buy my meds online from Canada. Started buying them online years ago because of the cost savings. At that time through my insurance company a 90-day supply of the 180 mg tablets they wanted over $1,300 but buying them from Canada and including shipping it came down to $144.10!

    You might want to try onlinepharmaciescanada.com for the meds. The meds are actually manufactured in Canada. The only drawback to them is that they only take American Express or you can have them take the money directly out of your checking account. They do require the hard copy of the prescription before shipping but if your doctor faxes the prescription to their toll-free fax number they will accept that.

    Chesapeake Woodworker

  • Sally Treppendahl

    April 17, 2024 at 3:01 pm

    I’ve has trouble with filling my prescription at CVS this time. Got a message April13 that pharmacy had ordered meds. Today when I checked they said my 90 day prescription (180 tablets) could not be filled until the middle of May. They did offer a 30 day supply which I took. I have been out for several days. Not good!

  • JoeATL28

    April 17, 2024 at 3:21 pm

    Yes, I ran into the same thing and like you, need the 180 MG daily and only take the 60mg as an emergency dose as needed. It isn’t the same to take 3 doses of the 60 MG as my body is used to the extended release. I’m in Georgia and CVS, Kroger, Walgreens and Publix were all out of it from their supplier so I missed a day and had to use the 60 MG for a day and was weak and had a tough few days until one specific Wal-Mart had some pills. Supposedly the supply will be back in a few weeks and I hope so as I’ll run out again soon.

  • andi_d

    April 17, 2024 at 4:06 pm

    I ran into the 180 mg shortage this weekend. I have it on automatic refill and didn’t realize that I was so low. I contacted my CVS on a Friday and was told that they had ordered it and believed it would be in stock on Mondays stock order. When I checked Monday, I was told that it was now back ordered. I asked if any other pharmacies in the area had it in stock, there were two pharmacies in all of North County San Diego, but I would have to verify by calling them directly. The closest one only had a 30 day supply and told me that I would have to pay “as is” since the prescription was for 90 days. At that point, I jumped for it. I already had one night of having to wake up in the middle of the night to make it through. I was not about to suffer more. Scary stuff!

  • Charles Karcher

    April 19, 2024 at 2:13 pm

    Original poster here. With about 20 days left I found an independent pharmacy that is able to get me a 90 day fill. None of the major pharmacy chains could fill my prescription though Walgreen’s could get me brand name Mestinon($1319 and no insurance coverage). Pick up Monday.

  • Darrylc

    April 19, 2024 at 3:20 pm

    I am in Orange County in Southern California

    After reading a post about the shortage I ordered a refill from Costco which is were I get my medication filled at their pharmacy at the best price

    This is the 180 mg ER version

    They normally don’t have it in stock but get it the next day

    This time they told me they did not show stock and that they would call me back when they got it

    I checked with them after not getting any calls a few days later

    I went over there on the weekend and was told they were waiting for a and gave me a 2 week lead time

    But 2 days later I received a text letting me know I could pick it up

    I originally started with the 60 mg 6 times a day but I had bad night time side effects of leg cramps

    I tried the 180 mg once in morning and one at night and now was able to cut it to one in the morning only and seemed to stop the nightly leg cramps

    I am currently trying to get my insurance prescription supplement to cover the 180 cost which ranges from $120 to $800 for 60 pill count

    The 60 mg are a fraction of the cost

    Hope this helps

Log in to reply.