Pyridostigminedosage

The recommended dosage is 30 mg orally every 8 hours, started at least one hour prior to exposure to Soman. At the first sign of soman nerve agent poisoning, discontinue pyridostigmine and administer atropine and 2-PAM. Evaluate use beyond 14 consecutive days in the context of the likelihood of soman exposure.

2.1 Important

Administration Information For Military Medical Use Only. Treatment and Protection for Soman Exposure Pyridostigmine bromide is for use as a pretreatment for exposure to soman nerve agent (see Treatment Timing). Pyridostigmine bromide alone will not protect against exposure to soman. Atropine and Pralidoxime The efficacy of pyridostigmine bromide is dependent upon the rapid use of atropine and pralidoxime (2-PAM) after soman exposure. Primary Protection The primary protection against exposure to chemical nerve agents consists of wearing protective garments including masks, hoods, and overgarments designed specifically for this use. Do not rely solely upon pretreatment with pyridostigmine bromide and the antidotes atropine and pralidoxime to provide complete protection from poisoning by soman nerve agent. Treatment Timing Pyridostigmine bromide is to be administered as pretreatment before exposure to soman nerve agent. If pyridostigmine bromide is taken immediately before exposure (e.g., when the gas attack alarm is given) or at the same time as poisoning by soman, it is not expected to be effective and may exacerbate the effects of a sublethal exposure to soman. Do not take pyridostigmine bromide after exposure to soman.

2.2 Recommended

Dosage, Administration, and Duration Dosage The recommended dosage of pyridostigmine bromide is one 30-mg tablet by mouth every 8 hours, started at least several hours prior to exposure to soman. Timing and Duration of Treatment Timing Pyridostigmine is a pretreatment for exposure to soman nerve agent. There is no known advantage to taking pyridostigmine bromide just prior to or concurrent with soman exposure. According to the mechanism of action of pyridostigmine bromide, pyridostigmine bromide is effective when it is given sufficiently in advance of soman poisoning to provide a pool of protected enzyme. Therefore, it is expected that pyridostigmine bromide will not be effective if administered just prior to or during exposure to soman. Duration At the first sign of nerve agent poisoning, discontinue pyridostigmine bromide and administer pretreatment with atropine and pralidoxime immediately. The benefits and risks of use beyond 14 consecutive days have not been definitively established; therefore, evaluate continued use beyond 14 consecutive days in the context of the likelihood of exposure to soman nerve agent. Missed Dose If a dose is missed, take the missed dose as soon as possible. Do not take double or extra doses.