Dosing & Uses
Dosage Forms & Strengths
Discontinued by manufacturer (6/25/2012)
Initial: 5 mg PO q6-8hr
Maintenance: 15-100 mg/day, usual 40 mg/day
Up to 50-75 mg PO q6-8hr used
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Increased bronchial secretions
Mechanical obstruction of intestinal or urinary tracts
Concurrent administration with belladona derivatives or ganglionic blocking agents such as mecamylamine
May develop anticholinergic insensitivity (withhold or reduce dosages until the patient becomes sensitive again
Use caution in patients intestinal obstruction, asthma, urinary tract obstruction, or Parkinson's disease
Narrow therapeutic index may increase risk of overdosage
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excretion in milk unknown/not recommended
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Acetylcholinesterase inhibitor; prevents hydrolysis of acetylcholine and increases its concentration at transmission sites in parasympathetic neurons and skeletal muscles
Poor oral absorption
Onset: 20-30 min
Duration: 4-8 hr