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Independent analysis of NHS open data
PharmaInsight

Neostigmine metilsulfate vs Pyridostigmine bromide

National NHS prescribing compared (Prescription Cost Analysis)
Data updated May 2026

Pyridostigmine bromide was dispensed 3,823.5× as often as Neostigmine metilsulfate in May 2026 — 7,647 items versus 2 in England.

2items

Neostigmine metilsulfate · May 2026

NHSBSA Prescription Cost Analysis

7,647items

Pyridostigmine bromide · May 2026

NHSBSA Prescription Cost Analysis

Figure 1. Neostigmine metilsulfate versus Pyridostigmine bromide: national items dispensed by month

▬ Neostigmine metilsulfate   ·   ╌ Pyridostigmine bromide

0 4k 8k Mar 2021 Jul 2022 Jan 2023 Jun 2023 Nov 2024 May 2025 May 2026 Pyridostigmine b… 2 Mar 2021: 1 Sep 2021: 3 Oct 2021: 2 Jun 2022: 1 Jul 2022: 1 Sep 2022: 1 Oct 2022: 3 Nov 2022: 3 Jan 2023: 1 Feb 2023: 1 Mar 2023: 1 Apr 2023: 1 Jun 2023: 1 Jul 2023: 2 Oct 2023: 1 Mar 2024: 1 Nov 2024: 1 Dec 2024: 2 Jan 2025: 1 Feb 2025: 1 May 2025: 3 Jul 2025: 1 Aug 2025: 1 Dec 2025: 1 Feb 2026: 4 Apr 2026: 1 May 2026: 2

Source: NHSBSA Prescription Cost Analysis, to May 2026

Neostigmine metilsulfate versus Pyridostigmine bromide, May 2026
Measure Neostigmine metilsulfate Pyridostigmine bromide
Items, May 2026 2 7,647
Items, last 12 months 19 91,321
Net ingredient cost, May 2026 £156 £152,454

See the full profile for Neostigmine metilsulfate or Pyridostigmine bromide.