The anticholinesterase drugs used in treating myasthenia gravis do not have a prolonged action. The ordinary dosage forms must be taken frequently during the day, and some patients have had to be awakened repeatedly during the sleeping period for medication. New dosage forms (slow-release tablets) have therefore been developed. Neostigmine bromide in the form of slowrelease tablets was tried in 85 patients, 54 of whom continued to take this form by preference at the conclusion of the experiment. Mestinon bromide in the form of slow-release tablets was similarly tried in 109 patients, 82 of whom continued to take this form at the conclusion of the experiment. The average duration of action of the slowrelease Mestinon tablet was approximately six hours. There were many individual differences in the responses to these dosageforms, and some patients preferre to take the slow-release tablets only at bedtime. Their greatest value was in eliminating the need of frequent interruptions of sleep.
Schwab RS, Osserman KE, Tether JE. TREATMENT OF MYASTHENIA GRAVISPROLONGED ACTION WITH MULTIPLE-DOSE TABLETS OF NEOSTIGMINE BROMIDE AND MESTINON BROMIDE. JAMA. 1957;165(6):671–674. doi:10.1001/jama.1957.02980240029008
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