Medication interaction hub

What Supplements Interact with Pyridostigmine Bromide?

Pyridostigmine Bromide brand names: Mestinon, Regonol. Every interaction below applies to the brands too.

39 Interactions 1 Major 28 Moderate 10 Minor
Curated & coded by · Clinical Pharmacist · Updated October 1, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Pyridostigmine Bromide? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Pyridostigmine Bromide against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

Activated charcoal is the single major-rated risk among the 39 supplements on file for pyridostigmine (Mestinon, Regonol), and it belongs at the top of your attention. Charcoal can soak up the medicine in the gut before it works, and for someone counting on pyridostigmine to keep muscles strong in myasthenia gravis, a blunted dose can mean real weakness. That is why this list deserves genuine vigilance, not a quick skim.

The rest sorts into two patterns. Roughly two dozen herbs, huperzine A among them, work in the same direction as the drug by raising acetylcholine, which can stack cholinergic side effects like cramping, sweating, and a slowed heartbeat. A smaller group of fibers and gums, glucomannan included, can change how well oral doses absorb, so space them well apart. None of the 28 moderate or 10 minor entries can undo a dose the way charcoal can, but each is worth checking below.

— , Clinical Pharmacist · July 18, 2026

Major 1 Moderate 28 Minor 10 No known interaction 1,413

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Top Ingredient Interactions

Pyridostigmine Bromide: Top Interactions at a Glance

The most significant Pyridostigmine Bromide supplement & herbal interactions, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 39 interacting ingredients — plus 1,413 more checked with no known interaction. See the complete ranked list.

Start here

The Major Interactions to Know About

The most clinically significant Pyridostigmine Bromide + supplement combinations in our database, best-documented first. Open any card for the full report.

Major Likelihood Probable Activated Charcoal + Pyridostigmine Bromidei

Activated charcoal reduces systemic exposure to many drugs, including those that undergo enterohepatic recirculation, regardless of the route of administration.

Read the full interaction
The complete list

Every Supplement Checked Against Pyridostigmine Bromide

All 1,452 ingredients in our database, ranked by severity — 39 with a Pyridostigmine Bromide interaction on file and 1,413 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Pyridostigmine Bromide?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Black Psyllium with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Black Psyllium + Pyridostigmine Bromide answer

Can you take Phosphatidylserine with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, phosphatidylserine might have additive effects with cholinergic drugs.

Full Phosphatidylserine + Pyridostigmine Bromide answer

Can you take Poria Mushroom with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, poria mushroom might have additive effects when used with cholinergic drugs.

Full Poria Mushroom + Pyridostigmine Bromide answer

Can you take Purple Nut Sedge with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro, purple nut sedge dose-dependently inhibits acetylcholinesterase (AChE).

Full Purple Nut Sedge + Pyridostigmine Bromide answer

Can you take Sage with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, sage might have additive effects when used with cholinergic drugs.

Full Sage + Pyridostigmine Bromide answer

Can you take Slippery Elm with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Full Slippery Elm + Pyridostigmine Bromide answer

Can you take Syrian Rue with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Syrian rue might increase the effects and adverse effects of cholinergic drugs.

Full Syrian Rue + Pyridostigmine Bromide answer

Can you take Teazle with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research suggests that teazle extract can inhibit acetylcholinesterase activity.

Full Teazle + Pyridostigmine Bromide answer

Can you take Thyme with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, concurrent use of cholinergic drugs and thyme essential oil might cause additive cholinergic effects.

Full Thyme + Pyridostigmine Bromide answer

Can you take Toothed Clubmoss with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Huperzine A, a constituent of toothed clubmoss, has demonstrated acetylcholinesterase inhibitory properties.

Full Toothed Clubmoss + Pyridostigmine Bromide answer

Can you take Tragacanth with Pyridostigmine Bromide?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, tragacanth might alter absorption of oral drugs.

Full Tragacanth + Pyridostigmine Bromide answer

Can you take Thyroid Extract with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Food and medications can interfere with thyroid hormone absorption.

Full Thyroid Extract + Pyridostigmine Bromide answer

Can you take Agar with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Agar forms a thick gel, which may disrupt the absorption of nutrients and medications.

Full Agar + Pyridostigmine Bromide answer

Can you take Algin with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, algin can alter the absorption of oral drugs.

Full Algin + Pyridostigmine Bromide answer

Can you take Blond Psyllium with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, psyllium might increase, decrease, or have no effect on the absorption of oral drugs.

Full Blond Psyllium + Pyridostigmine Bromide answer

Can you take Carob with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, carob might also impair the absorption of oral drugs.

Full Carob + Pyridostigmine Bromide answer

Can you take Karaya Gum with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Co-administration of oral drugs with bulk forming laxatives such as karaya gum may decrease, increase, or have no effect on the absorption o...

Full Karaya Gum + Pyridostigmine Bromide answer

Can you take Marshmallow with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, mucilage in marshmallow might impair absorption of oral drugs.

Full Marshmallow + Pyridostigmine Bromide answer

Can you take Xanthan Gum with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, xanthan gum can alter the absorption of oral drugs due to its fiber qualities.

Full Xanthan Gum + Pyridostigmine Bromide answer

Can you take Deanol with Pyridostigmine Bromide?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, deanol might increase the effects and adverse effects of cholinergic drugs.

Full Deanol + Pyridostigmine Bromide answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Pyridostigmine Bromide is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Pyridostigmine Bromide, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Pyridostigmine Bromide sits in 3 interaction categories. Open any one to see what the group means:

Cholinergic Drugs 21 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

21 of the supplement ingredients on this page reach Pyridostigmine Bromide through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Pyridostigmine Bromide through this category.

Acetylcholinesterase (Ache) Inhibitors 2 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

2 of the supplement ingredients on this page reach Pyridostigmine Bromide through this category.

About Pyridostigmine Bromide

Pyridostigmine is a cholinesterase inhibitor used to treat myasthenia gravis (oral solution, Mestinon), to reverse muscle relaxants after surgery (Regonol injection), and, for military use only, as pretreatment against soman nerve agent poisoning (pyridostigmine bromide tablets).

Generic name: Pyridostigmine Bromide  ·  Brand names: Mestinon, Regonol.

See the full Pyridostigmine drug information
Check a real product

Take a Supplement Product? Check the Whole Bottle Against Pyridostigmine Bromide

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Pyridostigmine Bromide.

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Pharmacist Counseling Corner

Pyridostigmine Bromide & Supplements: Common Questions

What supplements interact with Pyridostigmine Bromide?
More than you might expect — 39 in total, though they are far from equal: 1 are rated major, 28 moderate, and 10 minor. The ranked list on this page puts the ones that genuinely matter first, and every entry opens a full report on that exact pair. The highest-ranked right now: Activated Charcoal, Betel Nut, Coffee Charcoal.
Which Pyridostigmine Bromide supplement interactions are the most serious?
The 1 major-rated combination — led by Activated Charcoal — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Pyridostigmine Bromide?
Usually yes — most people on Pyridostigmine Bromide can take most supplements. The catch is the exceptions, and they aren't always the exotic ones (St. John's Wort trips up more prescriptions than almost anything sold next to it). Look up each ingredient you actually take in the list above, and treat "no known interaction" as a green-ish light, not a guarantee. Try the label scanner or the interaction checker.
Do brands like Mestinon have the same supplement interactions as Pyridostigmine Bromide?
Yes — Mestinon, Regonol all contain Pyridostigmine Bromide, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
What about Pyridostigmine Bromide and my other medications?
This page covers Pyridostigmine Bromide against supplements and herbal ingredients. Checking Pyridostigmine Bromide against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Pyridostigmine drug information.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of October 1, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.