Galantamine and Pyridostigmine interaction

Galantamine and Pyridostigmine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Pyridostigmine (Pyridostigmine bromide) label · effective 2026-05-13

Major

Pyridostigmine bromide extended-release tablets are contraindicated in patients with: Mechanical intestinal or urinary obstruction Known hypersensitivity to pyridostigmine or other anticholinesterase agents Mechanical intestinal or urinary obstruction.

Contraindicationsby drug classView label on DailyMed
Major

Known hypersensitivity to pyridostigmine or other anticholinesterase agents.

Contraindicationsby drug classView label on DailyMed
Moderate

Other Anticholinesterase Drugs Concomitant use of anticholinesterase drugs used in the treatment of glaucoma and pyridostigmine bromide may have an additive effect that may cause or exacerbate problems with night vision.

Drug interactionsby drug classView label on DailyMed

From the Galantamine label · effective 2026-06-01

Moderate

Gastrointestinal Conditions Through their primary action, cholinomimetics may be expected to increase gastric acid secretion due to increased cholinergic activity.

Warnings and precautionsby drug classView label on DailyMed
Moderate

An increase in cholinergic tone may worsen symptoms related to extrapyramidal disorders [see Adverse Reactions (6.2)].

Warnings and precautionsby drug classView label on DailyMed
Minor

Cholinomimetics may cause bladder outflow obstruction ( 5.5 )

Warnings and precautionsby drug classView label on DailyMed
Minor

Genitourinary Conditions Although this was not observed in clinical trials with galantamine, cholinomimetics may cause bladder outflow obstruction.

Warnings and precautionsby drug classView label on DailyMed
Minor

Pulmonary Conditions Because of its cholinomimetic action, galantamine should be prescribed with care to patients with a history of severe asthma or obstructive pulmonary disease.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.