Neostigmine

Description

Neostigmine is used to treat myasthenia gravis, a neuromuscular disorder where the muscles become weak and tire easily. It helps to reverse the neuromuscular blocking effects of muscle relaxants. This medicine is also used to treat urinary retention after surgery and paralytic ileus when the normal movements of the intestine are paralyzed.

Side effects

Major & minor side effects for Neostigmine

  • Twitches of the muscle visible under the skin
  • Loss of vision or blurred vision
  • Chest pain or discomfort
  • Fast, pounding, or irregular heartbeat
  • Lightheadedness, dizziness, or fainting
  • Constipation
  • Nausea and vomiting
  • Skin rash
  • Drowsiness
  • Increased watering of the mouth

Uses of Neostigmine

What is it prescribed for?

  • Myasthenia gravis
  • Urinary retention
  • Reversal of neuromuscular blockade
  • Paralytic ileus
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Concerns

Commonly asked questions

  • Onset of action
    Parenteral Form: The effect of this medicine can be observed within 1-20 minutes on an intravenous administration and within 20-30 minutes on an intramuscular administration of the dose. Oral Form: The amount of time required for this medicine to show its action is not clinically established.
  • Duration of effect
    Parenteral Form: The effect of this medicine lasts for an average duration of 1-2 hours after an intravenous administration and lasts for an average duration of 2.5-4 hours after an intramuscular administration of the dose. Oral Form: The amount of time for which this medicine remains active in the body is not clinically established.
  • Safe with alcohol?
    Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
  • Is it habit forming?
    No habit-forming tendencies were reported.
  • Usage in pregnancy?
    This medicine is not recommended for use in pregnant women unless absolutely necessary. Discuss all the risks and benefits with your doctor before receiving/taking this medicine.
  • Usage while breast-feeding?
    This medicine is not recommended for use in breastfeeding women unless necessary. The risks and benefits should be discussed with the doctor before receiving/taking this medicine.

Allergy

This medicine is not recommended for use if you have a known allergy to neostigmine or previous history of reaction to bromides.

Peritonitis

This medicine is not recommended for use in patients with a known history of peritonitis (inflammation of the thin layer of the abdominal wall) due to the increased risk of worsening of the patient's condition.

Urinary tract obstruction

This medicine is not recommended for use in patients with urinary tract obstruction (blockage of the outflow of urine) due to the increased risk of worsening of the patient's condition.

Mechanical Gastrointestinal Obstruction

This medicine is not recommended for use in patients with gastrointestinal tract obstruction due to the increased risk of worsening of the patient's condition.
Warnings for special population

Pregnancy

This medicine is not recommended for use in pregnant women unless absolutely necessary. Discuss all the risks and benefits with your doctor before receiving/taking this medicine.

Breast-feeding

This medicine is not recommended for use in breastfeeding women unless necessary. The risks and benefits should be discussed with the doctor before receiving/taking this medicine.
General warnings

Bradycardia

This medicine should be used with extreme caution in patients with bradycardia (low heart rate) due to the risk of worsening of the patient's condition. Appropriate corrective measures, dose adjustments or replacement with a suitable alternative should be considered based on the clinical condition.

Driving and operating machinery

This medicine may cause dizziness, fainting, drowsiness, or visual disturbances in some patients. It is advised that you do not perform any activities that require high mental alertness such as driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.

Hyperthyroidism

This medicine should be used with caution in patients with hyperthyroidism (a condition where the thyroid gland produces excess thyroid hormones) since it may worsen the patients' condition. Close monitoring of thyroid function is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Peptic ulcer

This medicine should be used with extreme caution in patients with a known history of peptic ulcer disease since it may worsen the patient's condition. Report any unusual side effects to the doctor on priority. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Missed Dose

Parenteral Form: Since this medicine is usually administered by a qualified healthcare professional in the clinical/hospital setting, the likelihood of a missed dose is very low. Oral Form: Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed one.

Overdose

Parenteral Form: Since this medicine is administered in the hospital setting by a qualified healthcare professional, the likelihood of an overdose is very less. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected. Oral Form: Seek emergency medical treatment or contact the doctor in case of an overdose.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Instructions

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine

Deflazacort

Propranolol

Tramadol

Atropine

Bupropion

Budesonide

Clozapine

Disease interactions

Respiratory Disorders

This medicine should be used with caution in patients with a known history of respiratory disorders such as asthma, chronic obstructive pulmonary disease, etc. since it may worsen the patient's condition. Close monitoring of respiratory function, appropriate dose adjustments, or replacement with a suitable alternative may be necessary based on the clinical condition of the patient.

Coronary Artery Disease

This medicine should be used with extreme caution in patients with coronary artery disease due to the risk of worsening of the patient's condition. Appropriate corrective measures, dose adjustments or replacement with a suitable alternative should be considered based on the clinical condition.

Parkinsonism

This medicine should be used with extreme caution in patients with parkinsonism due to the risk of worsening of the patient's condition. Appropriate corrective measures, dose adjustments or replacement with a suitable alternative should be considered based on the clinical condition.

Peptic ulcer disease

This medicine should be used with extreme caution in patients with a known history of peptic ulcer disease since it may worsen the patient's condition. Report any unusual side effects to the doctor on priority. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Seizures

This medicine should be used with caution in patients with a known history of seizures since it may worsen the patients' condition. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.

Hyperthyroidism

This medicine should be used with caution in patients with hyperthyroidism (a condition where the thyroid gland produces excess thyroid hormones) since it may worsen the patients' condition. Close monitoring of thyroid function is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.
Food interactions
Information not available.
Lab interactions
Information not available.
Parenteral Form: This medicine is usually administered in the clinical setting under the supervision of a qualified healthcare professional. Follow all the instructions given by your doctor. Inform the doctor if you have a known allergy to this medicine. Report all your current medicines as well as your medical conditions to the doctor before receiving this medicine. Oral form: Take this medicine with or without food. Do not take in larger or smaller amounts than advised/prescribed. Consult the doctor if you experience any undesirable effects. Do not stop taking the medicine before completion of the course/without consulting your doctor.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

May cause sleepiness

How it works
This medicine acts by inhibiting the action of an enzyme called cholinesterase in the body.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Acetylcholinesterase Inhibitors, Cholinergic muscle stimulants, Miscellaneous genitourinary tract agents

Schedule

Schedule H

[Internet]. Medicines.org.uk. 2018 [cited 5 December 2018]. Available from:

https://www.medicines.org.uk/emc/files/pil.2849.pdf

[Internet]. Drugbank.ca. 2018 [cited 5 December 2018]. Available from:

https://www.drugbank.ca/drugs/DB01400

DailyMed - Neostigmine- neostigmine injection [Internet]. Dailymed.nlm.nih.gov. 2019 [cited 4 March 2019]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=81243f47-bd25-bd02-518a-087badcca755

Neostigmine Methylsulfate Injection BP 2.5mg in 1ml - Summary of Product Characteristics (SmPC) - (eMC) [Internet]. Medicines.org.uk. 2019 [cited 4 March 2019]. Available from:

https://www.medicines.org.uk/emc/product/6268/smpc

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Information on this page was last updated on 4 Mar 2019

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We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.