Neostigmine
Other CNS Drugs · Anticholinesterase
Indications
Paralytic ileus, post-operative distension. Post- operative urinary retention. Myasthaenia gravis, diagnosis and treatment. Reversal of non-depolarizing neuromuscular blockade after surgery in conjunction with atropine. Bladder atony.
Dosage
Adults: Paralytic ileus, post-operative distension: 0.5-2.5 mg IM or SC as required. Post-operative urinary retention: 0.5- 2.5 mg IM or SC as required. Myasthaenia gravis, diagnosis: Including Elderly, IM: 0.02 mg/kg as a single dose. Myasthaenia gravis, treatment: Including Elderly, IM/IV/SC: 0.5-2.5 mg Every 1-3 hr. Max: 10 mg/24 hr. Reversal of non-depolarizing neuromuscular blockade after surgery in conjunction with atropine: Including Elderly: IV: 0.5-2.5 mg. Bladder atony: Including Elderly, IM/SC: Prevention: 0.25 mg every 4-6 hr for 2-3 days. Treatment: 0.5-1 mg every 3 hr for 5 doses after bladder has emptied. Children: Treatment of Myasthaenia gravis: Oral (as neostigmine bromide): Neonate, initially 1-2 mg, then 1-5 mg every 4 hr, give 30 minutes before feeds; Up to 6 yr, initially 7.5 mg repeated at suitable intervals throughout the day, total daily dose 15-90 mg; 6-12 yr,…
Administration
Administered by IM, SC, or slowly IV. Stability: Stored at room temperature and protect from light, freezing and temperatures of 40 degree centigrade or more.
Adverse Effects
Nausea, vomiting, increased salivation, diarrhoea and abdominal cramp.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Intestinal or urinary obstruction. Precautions: Bronchial asthma, cardiac disease, vagotonia, epilepsy, Parkinsonism, bradycardia, recent coronary occlusion, hypotension, peptic ulcer.
Interactions
Cyclopropane or halothane anaesthesia. Depolarising muscle relaxants. Anticholinergics.
Advice to Patient
Take with meals or milk. Contact prescriber if there is difficulty in breathing, severe or unrelieved diarrhoea, muscle weakness, vomiting, sweating, tearing, constant abdominal cramps. Be cautious at night because vision changes may occur. To minimize fatigue, keep a schedule of activities.
Pharmacokinetics
Onset: Oral: 45-75 mins. IV: 4-8 mins. IM/SC: 20-30 mins. Duration: 2-4 hrs. Absorption: Oral: Poorly absorbed. Metabolism: Hepatic. Also via cholinesterases. Half-life elimination: Oral: 42-60 mins. IM: 51-90 mins. IV: 24-113 mins. Time to peak, plasma: 1-2 hrs. Excretion: Urine (80% as unchanged drug and metabolites).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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