Pyridostigmine Bromide and Ultram ER

• Generic Name: pyridostigmine
• Dosage Forms: n.a.
• Other Brand Names: Mestinon, Mestinon Timespan, Regonol

Symptomatic management of myasthenia gravis to improve muscle strength.

Not effective in patients resistant to anticholinesterase drugs.

Has been used parenterally (IV or IM) for symptomatic treatment of acute exacerbations of myasthenia gravis or when oral therapy was impractical. However, the injectable preparation that was used for this indication no longer is commercially available in the US; the parenteral injection currently commercially available in the US does not include this use in its prescribing information.

Postoperative reversal of the effects of nondepolarizing neuromuscular blocking agents (e.g., gallamine, metocurine, tubocurarine [all no longer commercially available in the US], pancuronium).

Not effective and should not be used for reversal of depolarizing neuromuscular blocking agents (e.g., succinylcholine, decamethonium).

Preexposure prophylaxis against lethal effects of soman nerve agent poisoning in military combat personnel.

Used in conjunction with standard treatment of nerve agent poisoning (i.e., atropine and pralidoxime chloride) and other protective measures (e.g., masks, hoods, overgarments).

Discontinue use at first indication of nerve agent poisoning. Not for use after exposure to soman; not expected to be effective after such exposure and may exacerbate effects of sublethal exposure. (See Military Use for Soman Poisoning Prophylaxis in Boxed Warning.)

• Generic Name: tramadol
• Dosage Forms: tablet, extended release
• Other Brand Names: ConZip, Ultram, Ultram ER, Rybix ODT, Ryzolt

Ultram ER is an pain medicine similar to an opioid (sometimes called, a narcotic).

Ultram ER is used to treat moderate to severe pain.

The extended-release form of Ultram ER is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain.

Ultram ER may also be used for purposes not listed in this medication guide.