Prostigmine bromide, administered orally in the treatment of myasthenia gravis, was first tried by Everts,1 and there is no question as to the efficacy of this drug when taken by mouth. Viets and Schwab2 demonstrated that prostigmine bromide can be administered in entericcoated tablets without any alteration in its value. They also used the drug in eye drops and powder inhalations, without success, but had good results with the use of prostigmine bromide in suppositories. They advised that only oral and parenteral methods of administration be employed.
While prostigmine bromide is effective about an hour or an hour and a half after it is swallowed, nevertheless, under certain circumstances, this interval may be too great. My experience in the following cases shows that a more prompt response may be obtained by placing the prostigmine bromide tablet under the tongue and allowing it to be absorbed from there.
SALZER HM. SUBLINGUAL ABSORPTION OF PROSTIGMINE BROMIDE. Arch NeurPsych. 1941;45(6):1007-1008. doi:10.1001/archneurpsyc.1941.02280180119009