Neostigmine: functions, dosage, side effects, how to use it

What Drug Neostigmine?

What is neostigmine for?

Neostigmine is a drug that affects chemicals in the body that are involved in the communication between nerve impulses and muscle movement.

Neostigmine is used to treat symptoms of myasthenia gravis.

Neostigmine can also be used for purposes not listed in the medication guide.

How is neostigmine used?

Use as prescribed by your doctor. Do not use in doses larger or smaller or for longer than recommended. Follow the directions on your recipe label.

Take this medicine with food or milk if you have ulcers.

Do not crush, chew, or crush the extended-release tablet. Swallow the tablet whole. Crashing or opening a pill can cause too many levels of the drug to be released at one time.

The amount and timing of using this medication are critical to the success of your treatment. Follow your doctor's instructions on how much medicine you should take and when to take it. You may need to take neostigmine for the same amount of time each time.

Your doctor may change your dose from time to time to make sure you get the best results. You may be asked to record the results for each day when you take each dose of medicine and how long the effects last. This will help your doctor determine if the dosage needs to be adjusted.

If you need surgery, tell your surgeon ahead of time that you are taking neostigmine. You may have to temporarily stop taking your medication.

How is neostigmine stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Neostigmine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dose of neostigmine for adults?

Dosage for reversal of neuromuscular blockade in adults

Initial dose: 0.03 - 0.07 mg / kg intravenously for at least 1 minute
Maximum dose: 0.07 mg / kg or up to 5 mg total, as long as less than allowed

Dosage for Gravis Myasthenia in adults

Oral
15-375 mg orally, every day
Average dosage: 150 mg (10 tablets) orally over a 24 hour period

Parenteral
1 mL of a 1: 2000 solution (0.5 mg) subcutaneously or intramuscularly

Dosage for Urine Retention in Adults

Prevention of postoperative distension:
Initial dose: 0.25 mg subcutaneously or intramuscularly as soon as possible after surgery
Duration of therapy: Repeat every 4 to 6 hours for 2 to 3 days.
Postoperative Distention Treatment: 1 mL of a 1: 2000 solution (0.5 mg) subcutaneously or intramuscularly

Prevention of urinary retention:
Initial dose: 0.25 mg subcutaneously or intramuscularly as soon as possible after surgery
Duration of therapy: Repeat every 4 to 6 hours for 2 to 3 days
Urine retention treatment:
Initial: 1 mL of a 1: 2000 solution (0.5 mg) subcutaneously or intramuscularly
Duration of therapy: After the patient has canceled to continue to 0.5 mg subcutaneously or intramuscularly every 3 hours with at least 5 injections.

What is the dose of neostigmine for children?

Dosage for Reversal of Neuromuscular Blockade in children

Initial dose: 0.03 - 0.07 mg / kg intravenously for at least 1 minute
Maximum dose: 0.07 mg / kg or up to 5 mg total, as long as less than allowed

In what dosage is neostigmine available?

Solution, injection: 1mg / mL

Neostigmine side effects

What side effects can be experienced due to neostigmine?

Seek immediate medical help if you experience any of the following signs of an allergic reaction: hives, difficulty breathing, swelling of the face, lips, tongue, or throat.

Stop using Neostigmine and call your doctor if you have any of the following side effects:

• extreme muscle weakness
• slurred speech, vision problems
• feeling like you might pass out
• severe stomach cramps or diarrhea
• difficulty breathing, coughing up mucus
• heart rate getting faster or slower
• seizures
• your symptoms worsen or there is no improvement in your myasthenia gravis symptoms

The more common side effects include:

• headache, drowsiness
• mild nausea, vomiting, gas
• urinating more than usual
• cold sweat, heat or tingling feeling; or
• mild or itchy rash

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Neostigmine Drug Warnings and Cautions

What should be known before using neostigmine?

Before using Neostigmine,

• tell your doctor and pharmacist if you have an allergy to neostigmine or any other medication

• tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, including vitamins

• tell your doctor if you have bladder or bowel obstruction, or a severe stomach disorder called peritonitis

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using neostigmine contact your doctor.

Is neostigmine safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

A = Not at risk

B = No risk in several studies

C = May be risky

D = There is positive evidence of risk

X = Contraindicated

N = Unknown
There are not sufficient studies in breastfeeding women to know the risks to the baby when using this medicine during breastfeeding. Consider the benefits and risks before using this medication while breastfeeding.

Neostigmine Drug Interactions

What drugs might interact with neostigmine?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Tell your doctor about all other medicines you take with neostigmine, including

• atropine (Atreza, Sal-tropine)
• belladonna (Donnatal, and others)
• benztropine (Cogentin)
• clidinium (Quarzan)
• clozapine (Clozaril, FazaClo)
• dimenhydrinate (Dramamine)
• methscopolamine (Pamine), scopolamine (Transderm Scop)
• glycopyrrolate (Robinul)
• mepenzolate (Cantil)
• antibiotics such as neomycin (Mycifradin, Neo Fradin, Neo Tab), kanamycin (Kantrex), or streptomycin, tobramycin (Nebcin, Tobi)
• medicines for the bladder or urinary tract such as darifenacin (Enablex), flavoxates (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare)
• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva)
• fever medicine, allergy medicine, or sleeping pills containing antihistamines such as diphenhydramine (Tylenol PM) or doxylamine (Unisom)
• heart medications such as quinidine (Quin-G), procainamide (Procan, Pronestyl), Disopyramide (Norpace), flecainide (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine)
• medications to treat Alzheimer's dementia, such as donepezil (Aricept), rivastigmine (Exelon), or tacrine (Cognex) or
• steroids such as betamethasone (Celestone) or dexamethasone (Cortastat, Dexasone, Solurex, DexPak).

Can food or alcohol interact with neostigmine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with neostigmine?

Any other health conditions you have can affect the use of this drug. Always tell your doctor if you have other health problems, in particular:

• • intestinal blockage (blockage of the intestines or stomach)
  • kidney blockage (blockage of urine flow) or
    Peritonitis (inflamed stomach lining) - should not be used in patients with this condition
  • asthma
  • bradycardia (slow heart rate)
  • heart attack, just happened
  • heart rhythm problems
  • hyperthyroidism
  • seizures

• ulcer - use with caution. May make the condition worse.

Neostigmine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Possible overdose symptoms include nausea, vomiting, diarrhea, stomach cramps, sweating, blurred vision, saliva, and weak or shallow breathing.

Muscle weakness, or no change in your myasthenia gravis symptoms, may also be signs of an overdose.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.