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Neostigmine Brand Names- BLOXIVERZ | Prostigmin
What is Neostigmine
Neostigmine is an oral and parenteral parasympathomimetic agent (cholinesterase inhibitor).
It is similar to, but shorter-acting than, pyridostigmine.
Neostigmine bromide is the oral form of the drug, while neostigmine methylsulfate is the intravenous (IV), intramuscular (IM), and subcutaneous (SC) form. Both formulations (bromide and methylsulfate) are approved for the symptomatic treatment of myasthenia gravis when given via oral, SC, and IM routes.
Neostigmine methylsulfate is also indicated for reversal of the effects of non-depolarizing neuromuscular blocking agents when given IV and for the prevention and treatment of post-operative distention and urinary retention (after exclusion of a mechanical obstruction) when given as an IM or SC injection.
Neostigmine was approved by the FDA in 1939
Indications
- acute colonic pseudo-obstruction
- ileus
- myasthenia gravis
- myasthenia gravis diagnosis
- neuromuscular blockade reversal
- urinary retention
Side Effects
- abdominal pain
- angioedema
- arrhythmia exacerbation
- arthralgia
- AV block
- bradycardia
- bronchial secretions
- bronchospasm
- cardiac arrest
- coma
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysarthria
- dyspnea
- erythema multiforme
- fever
- flatulence
- flushing
- headache
- hypersalivation
- hypotension
- increased urinary frequency
- insomnia
- lacrimation
- miosis
- muscle cramps
- myasthenia
- nausea
- peripheral edema
- premature labor
- pruritus
- rash
- respiratory arrest
- respiratory depression
- seizures
- shivering
- sinus tachycardia
- syncope
- urticaria
- visual impairment
- vomiting
- weakness
- xerostomia
Monitoring Parameters
- neurologic function
Contraindications
- acute bronchospasm
- asthma
- bradycardia
- breast-feeding
- bromide hypersensitivity
- cardiac arrhythmias
- cardiac disease
- cholinesterase inhibitor toxicity
- geriatric
- GI obstruction
- hepatic disease
- hyperthyroidism
- hypotension
- myasthenia gravis
- peptic ulcer disease
- peritonitis
- pregnancy
- renal disease
- renal failure
- renal impairment
- seizure disorder
- urinary tract obstruction
Interactions
- Ambenonium Chloride
- Amifampridine
- Amoxapine
- Articaine; Epinephrine
- Atracurium
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Beclomethasone
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Chloroprocaine
- Cholinergic agonists
- Ciclesonide
- Cisatracurium
- Cocaine
- Corticosteroids
- Cortisone
- Deflazacort
- Dexamethasone
- Dicyclomine
- Digoxin
- Disopyramide
- Edrophonium
- Etomidate
- Fludrocortisone
- Flunisolide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Fospropofol
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Halogenated Anesthetics
- Homatropine; Hydrocodone
- Hydrocortisone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Indacaterol; Glycopyrrolate
- Ketamine
- Levobupivacaine
- Lidocaine
- Lidocaine; Prilocaine
- Maprotiline
- Mecamylamine
- Mepivacaine
- Mepivacaine; Levonordefrin
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methylprednisolone
- Mivacurium
- Mometasone
- Nonsteroidal antiinflammatory drugs
- Oxybutynin
- Pancuronium
- Physostigmine
- Prednisolone
- Prednisone
- Prilocaine
- Prilocaine; Epinephrine
- Procainamide
- Procaine
- Propantheline
- Propofol
- Pyridostigmine
- Quinine
- Rocuronium
- Ropivacaine
- Scopolamine
- Succinylcholine
- Tetracaine
- Triamcinolone
- Tricyclic antidepressants
- Trihexyphenidyl
- Vecuronium
