Dosing & Uses
Dosage Forms & Strengths
injectable solution (methylsulfate salt; Bloxiverz)
- 0.5mg/mL
- 1mg/mL
tablet (bromide salt; Prostigmin)
- 15mg
Myasthenia Gravis
Acute: 0.5-2.5 mg IV/IM/SC qDay
Maintenance: 15-375 mg/day PO divided q6-8hr
Use injectable with 0.6-1.2 mg atropine IV to counteract muscarinic effects
Myasthenia Gravis Diagnosis
Discontinue all anticholinesterase agents for >8 hr
Give atropine 0.011 mg/kg IV (if IM give 30 minutes before) with neostigmine 0.022 mg/kg IM
If cholinergic response, stop test and give 0.4-0.6 mg atropine IV
If inconclusive, retest another day with neostigmine 0.031 mg/kg IM preceded by 0.016 mg/kg atropine
Nondepolarizing Neuromuscular Blockade, Reversal
0.03-0.07 mg/kg IV will generally achieve a TOF twitch ratio of 90% within 10-20 minutes of administration
Not to exceed 0.07 mg/kg or a cumulative total of 5 mg, whichever dose is less Inject by slow IV over at least 1 minute
Dose selection should be based on the extent of spontaneous recovery that has occurred at the time of administration, the half-life of the NMBA being reversed, and whether there is a need to rapidly reverse the NMBA
Administer an IV anticholinergic (eg, atropine, glycopyrrolate) prior to, or concomitantly with neostigmine for NMB reversal; if bradycardia present, give anticholinergic before neostigmine
0.03 mg/kg
- Use for reversal of NMBAs with shorter half-lives (eg, rocuronium), OR
- When the first twitch response to the TOF stimulus is substantially >10% of baseline or when a second twitch is present
0.07 mg/kg
- Use for NMBAs with longer half-lives (eg, vecuronium, pancuronium), OR
- When the first twitch response is relatively weak (ie, not substantially >10% of baseline), OR
- There is need for more rapid recovery
Post-Op Distention or Urinary Retention
Prevention: 0.25mg IM after surgery. Repeat q4-6hr for 2-3 days
Treatment: 0.5-1 mg IM and up to q3hr PRN (for 5 doses for retention)
Colonic Pseudo-obstruction (Orphan)
Orphan designation for treatment of acute colonic pseudo-obstruction
Orphan sponsor
- Luitpold Pharmaceuticals, Inc.; One Luitpold Drive, P. O. Box 9001; Shirley, NY 11967
Administration
IV TOF monitoring for NMB reversal
- Peripheral nerve stimulation devices capable of delivering a train-of-four (TOF) stimulus are essential to effectively and safely adjust IV dose
- There must be a twitch response to the first stimulus in the TOF of at least 10% of its baseline level (ie, the response before NMBA administration, prior to neostigmine)
Dosage Forms & Strengths
injectable solution (methylsulfate salt; Bloxiverz)
- 0.5mg/mL
- 1mg/mL
tablet (bromide salt; Prostigmin)
- 15mg
Myasthenia Gravis Diagnosis
Use with atropine
Myasthenia Gravis Treatment
Use with atropine
0.01-0.04 mg/kg IV/IM/SC q2-3hr PRN
2 mg/kg/day divided q4hr PO; no more than 375mg/day
Nondepolarizing Neuromuscular Blockade, Reversal
Adult guidelines should be followed when administered to pediatric patients, including neonates; pediatric patients require doses similar to those for adults
0.03-0.07 mg/kg IV will generally achieve a TOF twitch ratio of 90% within 10-20 minutes of administration
Not to exceed 0.07 mg/kg or a cumulative total of 5 mg, whichever dose is less Inject by slow IV over at least 1 minute
Dose selection should be based on the extent of spontaneous recovery that has occurred at the time of administration, the half-life of the NMBA being reversed, and whether there is a need to rapidly reverse the NMBA
Administer an IV anticholinergic (eg, atropine, glycopyrrolate) prior to, or concomitantly with neostigmine for NMB reversal; if bradycardia present, give anticholinergic before neostigmine
0.03 mg/kg
- Use for reversal of NMBAs with shorter half-lives (eg, rocuronium), OR
- When the first twitch response to the TOF stimulus is substantially >10% of baseline or when a second twitch is present
0.07 mg/kg
- Use for NMBAs with longer half-lives (eg, vecuronium, pancuronium), OR
- When the first twitch response is relatively weak (ie, not substantially >10% of baseline), OR
- There is need for more rapid recovery
Administration
IV TOF monitoring for NMB reversal
- Peripheral nerve stimulation devices capable of delivering a train-of-four (TOF) stimulus are essential to effectively and safely adjust IV dose
- There must be a twitch response to the first stimulus in the TOF of at least 10% of its baseline level (ie, the response before NMBA administration, prior to neostigmine)
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (2)
- ponesimod
ponesimod, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, neostigmine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, withdraw anticholinesterase agents at least 24 hours before initiating corticosteroid therapy.
Monitor Closely (65)
- aclidinium
neostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amifampridine
amifampridine and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- amitriptyline
neostigmine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- amoxapine
neostigmine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- anticholinergic/sedative combos
neostigmine increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atracurium
neostigmine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine
neostigmine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine IV/IM
neostigmine increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- belladonna alkaloids
neostigmine increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- belladonna and opium
neostigmine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bethanechol
bethanechol and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- carbachol
carbachol and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- cevimeline
cevimeline and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- cisatracurium
neostigmine increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clomipramine
neostigmine increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclizine
neostigmine increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclobenzaprine
neostigmine increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- darifenacin
neostigmine increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dicyclomine
neostigmine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diphenhydramine
neostigmine increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil
donepezil and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- dosulepin
neostigmine increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
neostigmine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- echothiophate iodide
echothiophate iodide and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- fesoterodine
neostigmine increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- flavoxate
neostigmine increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- galantamine
galantamine and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate
neostigmine increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate inhaled
neostigmine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- henbane
neostigmine increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- homatropine
neostigmine increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- huperzine A
huperzine A and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine
neostigmine increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine spray
neostigmine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- imipramine
neostigmine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ipratropium
neostigmine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofepramine
neostigmine increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- maprotiline
neostigmine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meclizine
neostigmine increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methscopolamine
neostigmine increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
neostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- onabotulinumtoxinA
neostigmine increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- orphenadrine
neostigmine increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin
neostigmine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin topical
neostigmine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin transdermal
neostigmine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pancuronium
neostigmine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- physostigmine
neostigmine and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- pilocarpine
neostigmine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.
- pralidoxime
neostigmine increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- propantheline
neostigmine increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
neostigmine increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pyridostigmine
neostigmine and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- rapacuronium
neostigmine increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- rivastigmine
neostigmine and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- rocuronium
neostigmine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scopolamine
neostigmine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- solifenacin
neostigmine increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- succinylcholine
neostigmine and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.
- tiotropium
neostigmine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolterodine
neostigmine increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trimipramine
neostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trospium chloride
neostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- umeclidinium bromide
neostigmine increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.
- vecuronium
neostigmine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (22)
- acebutolol
acebutolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- atenolol
atenolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- betaxolol
betaxolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- bisoprolol
bisoprolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- carvedilol
carvedilol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- celiprolol
celiprolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- desipramine
neostigmine increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- donepezil
donepezil increases effects of neostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- esmolol
esmolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- galantamine
galantamine increases effects of neostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- labetalol
labetalol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- metoprolol
metoprolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- nadolol
nadolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- nebivolol
nebivolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pantothenic acid
pantothenic acid, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.
- penbutolol
penbutolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pindolol
pindolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- procainamide
procainamide decreases effects of neostigmine by pharmacodynamic antagonism. Minor/Significance Unknown.
- propranolol
propranolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- sotalol
sotalol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- timolol
timolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- trazodone
neostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Allergic: Allergic reactions and anaphylaxis
Neurologic: Dizziness, convulsions, loss of consciousness, drowsiness, headache, dysarthria, miosis and visual changes
Cardiovascular: Cardiac arrhythmias (including bradycardia, tachycardia, A-V block and nodal rhythm) and nonspecific EKG changes have been reported, as well as cardiac arrest, syncope and hypotension (predominantly with parenteral dosage form)
Respiratory: Increased oral, pharyngeal and bronchial secretions, and dyspnea; respiratory depression, respiratory arrest and bronchospasm have been reported following the use of the injectable form
Dermatologic: Rash and urticaria
Gastrointestinal: Nausea, emesis, flatulence, and increased peristalsis and salivation
Genitourinary: Urinary frequency
Musculoskeletal: Muscle cramps and spasms, arthralgia
Miscellaneous: Diaphoresis, flushing and weakness
Warnings
Contraindications
Hypersensitivity, previous history of reaction to bromides
Peritonitis or mechanical GI or urinary tract obstruction
Cautions
To lessen risk of bradycardia, administer glycopyrrolate or atropine sulfate prior to therapy
Caution in epilepsy, bronchial asthma, bradycardia, recent coronary occlusion, vagotonia, hyperthyroidism, cardiac arrhythmias, peptic ulcer
In patients with certain cardiovascular conditions such as coronary artery disease, cardiac arrhythmias or recent acute coronary syndrome, risk of blood pressure and heart rate complications may be increased; risk of these complications may also be increased in patients with myasthenia gravis; standard antagonism with anticholinergics (eg, atropine) is generally successful to mitigate risk of cardiovascular complications
Neonates; because of self-limiting nature of myasthenia gravis, reduce daily dosage gradually released until drug can be withdrawn
Avoid large doses in situations where there might be an increased absorption rate from the intestinal tract; caution when coadministered with anticholinergic drugs because of decreased GI motility
Differentiate between myasthenic crisis and cholinergic crisis caused by overdosage of neostigmine; both conditions result in extreme muscle weakness but require radically different treatment
Large doses administered when neuromuscular blockade is minimal can produce neuromuscular dysfunction; the dose should be reduced if recovery from neuromuscular blockade is nearly complete
Anticholinesterase insensitivity can develop
If excess cholinergic symptoms develop, discontinue therapy
Atropine and epinephrine must be available to treat a hypersensitivity reaction
Not recomended for use in patients with vagotonia
May prolong the phase 1 block of depolarizing muscle relaxants
Pregnancy & Lactation
Pregnancy
There are no adequate or well-controlled studies in pregnant women; not known whether neostigmine can cause fetal harm or affect reproductive capacity; should administer only if clearly needed
Anticholinesterase drugs, including neostigmine, may cause uterine irritability and induce premature labor when administered to pregnant women near term
Animal data
- No adverse effects were noted in rats or rabbits treated with human equivalent doses of neostigmine methylsulfate doses up to 8.1 and 13 mcg/kg/day, respectively, during organogenesis (0.1 to 0.2 times the maximum recommended human dose of 5 mg/60 kg person/day based on body surface area comparisons)
Lactation
The drug has not been studied in lactating women; not known whether neostigmine methylsulfate is present in human milk, or has effects on milk production or breastfed child; the developmental and health benefits of breastfeeding should be considered along with mother’s need for therapy and any potential adverse effects on breastfed child from drug or from underlying maternal condition
Pregnancy Categories
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.Pharmacology
Mechanism of Action
Competitive inhibitor of cholinesterase resulting in decreased hydrolysis of acetylcholine by cholinesterase; by reducing the breakdown of acetylcholine, neostigmine increases acetylcholine in the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular blocking agents, and reverses the neuromuscular blockade
Absorption
Bioavailability: 1-2% (PO); general PO:IV equivalence ~15 mg neostigmine bromide PO is equivalent to 0.5 mg neostigmine methylsulfate parenteral
Onset: 1-20 min (IV); 20-30 min (IM)
Duration: 2.5-4 hr (IM); 1-2 hr (IV)
Peak plasma time: 30 min (IM); 1-2 hr (PO)
Distribution
Protein bound: 15-25% to albumin (PO)
Metabolism
Liver microsomal enzymes and hydrolysis by cholinesterase enzymes
Elimination
Half-Life: 47-60 min (IV); 51-90 min (IM); 42-60 min (PO)
Excretion: 50% urine
Administration
IV Incompatibilities: none specified
IV Administration: slow IV injection
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 3 mg/3 mL (1 mg/mL) solution |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 1 mg/mL vial |  | |
| neostigmine methylsulfate intravenous - | 0.5 mg/mL vial |  | |
| Bloxiverz intravenous - | 1 mg/mL vial |  | |
| Bloxiverz intravenous - | 0.5 mg/mL vial |  | |
| Bloxiverz intravenous - | 0.5 mg/mL vial |  | |
| Bloxiverz intravenous - | 1 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
neostigmine methylsulfate intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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