Mestinon in 2026: What's the Current Situation?

If you take Mestinon (Pyridostigmine Bromide) for myasthenia gravis, POTS, or another condition, you've likely experienced — or at least heard about — the supply problems that have affected this medication since 2024. In this update, we'll break down what's happening with Mestinon availability in 2026, what it costs, and what you can do to make sure you don't run out.

Is Mestinon Still in Shortage?

The short answer: it depends on the formulation.

The extended-release (ER) 180 mg tablets have been the hardest hit. Since mid-2024, generic manufacturers Alvogen and Rising Pharmaceuticals have had Pyridostigmine ER on back order with no firm release date. Bausch Health's brand-name Mestinon Timespan has remained more consistently available, but at a significantly higher cost.

The immediate-release (IR) 60 mg tablets have been more reliably stocked. While some patients have reported occasional spot shortages, the IR formulation is generally available at most pharmacies.

The oral solution (syrup) has also been relatively unaffected by the shortage.

Notably, the FDA has not formally listed Pyridostigmine on its drug shortage database, even though patients and pharmacists have widely reported supply problems — particularly for the ER formulation.

Why Is Mestinon Hard to Find?

Several factors are driving the supply issues:

• Limited generic manufacturers: Only a handful of companies produce Pyridostigmine ER, making the supply chain vulnerable to disruptions
• Increased off-label demand: Growing use for POTS, Long COVID, and ME/CFS has significantly expanded the patient population beyond traditional myasthenia gravis patients
• Manufacturing disruptions: Back orders from major generic suppliers have reduced available inventory
• Distribution challenges: Chain pharmacies may deprioritize lower-volume specialty medications

For a deeper dive into these causes, read our article on why Mestinon is so hard to find.

How Much Does Mestinon Cost in 2026?

Cost varies significantly depending on the formulation and whether you have insurance:

• Generic Pyridostigmine IR 60 mg (90 tablets): $26–$50 with a discount card like GoodRx or SingleCare
• Generic Pyridostigmine ER 180 mg (30 tablets): $105–$150 with a discount card; retail cash price can be $700+
• Brand-name Mestinon Timespan 180 mg: Significantly more expensive; may be $800+ without insurance

If cost is a concern, check out our full guide on how to save money on Mestinon, which covers coupons, discount cards, and patient assistance programs.

Are There Any New Options?

While no new Pyridostigmine products have launched recently, patients have a few additional avenues:

• Formulation switching: If you can't find the ER version, your doctor may switch you to the IR tablets or oral solution
• Compounding pharmacies: Some compounding pharmacies can prepare Pyridostigmine in custom doses and formulations
• Patient assistance: Bausch Health's Patient Assistance Program (bauschhealthpap.com) can provide brand-name Mestinon for free to qualifying patients

The myasthenia gravis treatment landscape is also evolving. Newer therapies targeting complement proteins and neonatal Fc receptors (like Vyvgart and Ultomiris) are expanding options for MG patients, potentially reducing reliance on Pyridostigmine for some individuals.

How to Find Mestinon in Stock

Here are the most effective strategies for finding Mestinon right now:

1. Use Medfinder to check real-time pharmacy availability near you
2. Call independent pharmacies — they often use different wholesalers than chain pharmacies
3. Try mail-order pharmacies like Express Scripts or Amazon Pharmacy
4. Ask your pharmacy about partial fills — get what's available now and the rest when stock arrives
5. Refill early — most insurance allows refills 7–10 days before you run out

For more detailed tips, see our guide on how to find Mestinon in stock near you.

Final Thoughts

The Mestinon supply situation in 2026 remains challenging, especially for the ER formulation. But by staying informed, planning ahead, and using the right tools, most patients can still access the medication they need.

If you're worried about side effects or drug interactions with your current Mestinon regimen, we've got guides for those too. And if you need to explore other treatment options, read about alternatives to Mestinon.

Your health shouldn't depend on a supply chain. Use Medfinder to stay one step ahead.