Medicines & Supplements A to Z > Distigmine


Last updated on 16/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions  |   Tips  |   Where To Buy  

GENERIC NAME: Distigmine



DRUG CLASS: Central nervous system agents

SUB CLASS: Acetylcholinesterase inhibitors

USED FOR: Myasthenia gravis, Neuromuscular disorders, Postoperative urinary retention, Chronic hypotonic constipation in megacolon patients, Neurogenic bladder disorders


What is Distigmine for?

Distigmine belongs to a class of medications called central nervous system agents inhibiting an enzyme acetylcholinesterase to slow down the breakdown of a neurotransmitter acetylcholine. Distigmine is used for treating myasthenia gravis, neuromuscular disorders, postoperative urinary retention, chronic hypotonic constipation in megacolon patients and neurogenic bladder disorders.

How to use it?

Distigmine is taken orally as tablets with fluid like a cup of water on an empty stomach 30 minutes before breakfast.

Chronic hypotonic constipation in megacolon patients
Adult and elderly
The initial dose is 2.5 mg once daily and increases by 2.5 mg daily every 3 days up to 10 mg daily if necessary. Continue until constipation is resolved.

Myasthenia gravis
Adult and elderly
The initial dose is 5 mg once daily and increases by 2.5 mg daily every week up to 10 mg daily.

Peripheral paralysis
Adult and elderly
15 mg daily.

Urinary bladder hypotonia
Adult and elderly
The initial dose is 5 mg once daily and increases to up to 15 mg daily if necessary.

Vesicosphincteral dysfunction
Adult and elderly
The initial dose is 5 mg once daily until symptoms improve. The maintenance dose is 5-10 mg once every 2-3 days.

What are the side effects of Distigmine?

Common side effects of Distigmine include bradycardia, excessive sweating, diarrhoea, nausea and vomiting.

Who should not take Distigmine?

– People allergic to Distigmine, Bromine or any component of the formulation.
– Patients with bowel or urinary tract obstruction or spasm.
– Patients with gastrointestinal hyperacidity or hyperperistalsis.
– Patients with Parkinson’s Disease.
– Patients with Epilepsy.

There are other contraindications. Notify your physician of your condition before being administered with Distigmine.

Pharmacist Tips:

– Keep taking Distigmine even if you feel better.
– Eat food rich in fibre like vegetables and fruits to avoid constipation.
– Drink more water for those with hypotonic bladder as it can dilute your urine and actually causes less irritation to your bladder. This can reduce your urge to urinate.

Common dosing schedule:
Distigmine is usually taken once daily with fluid like a cup of water on an empty stomach 30 minutes before breakfast.

This schedule is for reference only, adjustments may be made according to individual needs. 

Some common medications Distigmine may interact with:
– Aminoglycosides, e.g. Gentamicin, Amikacin, Streptomycin
– Beta-blockers, e.g. Bisoprolol, Metoprolol, Propranolol
– Anticholinergic agents, e.g. Atropine, Benztropine, Benzhexol
– Cholinergic agonists, e.g. Pilocarpine, Donepezil, Parathion
– Corticosteroids, e.g. Hydrocortisone, Dexamethasone, Prednisolone

Distigmine may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Distigmine in Hong Kong?

In Hong Kong, Distigmine is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at

Need more information?

For detailed information about the use of Distigmine in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.