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neostigmine (Injection route)

Pronunciation

nee-oh-STIG-meen

Available Dosage Forms:

  • Solution
  • Injectable

Therapeutic Class: Central Nervous System Agent

Pharmacologic Class: Cholinesterase Inhibitor

Uses For neostigmine

Neostigmine injection is used to treat a muscle disease called myasthenia gravis.

Neostigmine injection is also used to prevent or treat certain kidney or intestinal problems. neostigmine is also given after surgery to help reverse the effects of certain types of medicines that have been used to relax the muscles.

neostigmine is available only with your doctor's prescription.

Before Using neostigmine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For neostigmine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to neostigmine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of neostigmine injection in children. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Bloxiverz™ in children. However, infants and small children may be more sensitive to the effects of neostigmine.

Geriatric

No information is available on the relationship of age to the effects of neostigmine injection in geriatric patients.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Bloxiverz™ in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution for patients receiving Bloxiverz™.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving neostigmine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using neostigmine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Succinylcholine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of neostigmine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or
  • Bradycardia (slow heartbeat) or
  • Coronary artery disease (heart disease) or
  • Heart attack, recent or
  • Heart rhythm problems or
  • Hypotension (low blood pressure) or
  • Overactive thyroid or
  • Seizures or
  • Stomach ulcer—Use with caution. May make these conditions worse.
  • Intestinal (bowel) blockage or
  • Peritonitis (swelling of the lining of the abdomen or stomach) or
  • Urinary tract blockage—Should not be used in patients with these conditions.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of neostigmine

A nurse or other trained health professional will give you neostigmine. neostigmine is given through a needle placed into one of your veins, under your skin, or into your muscle.

Precautions While Using neostigmine

Your doctor will only give you a few doses of neostigmine until your condition improves, and then you will be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

neostigmine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Blurred or loss of vision
  • chest pain, discomfort, or tightness
  • confusion
  • difficult or labored breathing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • fast, slow, pounding, or irregular heartbeat or pulse
  • lightheadedness, dizziness, or fainting
  • sweating
  • twitches of the muscle visible under the skin
  • unusual tiredness or weakness
Incidence not known
  • Changes in patterns and rhythms of speech
  • cough
  • difficulty in moving
  • difficulty swallowing
  • disturbed color perception
  • double vision
  • halos around lights
  • hives
  • irregular, fast or slow, or shallow breathing
  • itching
  • loss of consciousness
  • muscle cramps and spasms
  • muscle pain or stiffness
  • night blindness
  • no blood pressure or pulse
  • noisy breathing
  • overbright appearance of lights
  • pain in the joints
  • pale or blue lips, fingernails, or skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • skin rash
  • slurred speech
  • stopping of the heart
  • trouble in speaking
  • tunnel vision
  • unconsciousness

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of Overdose
  • Constipation
  • decreased sexual ability
  • difficult urination
  • dry mouth
  • enlarged pupils
  • muscle weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at site
  • drowsiness
  • headache
  • increased watering of the mouth
  • nausea
  • sleeplessness
  • sore throat
  • trouble sleeping
  • unable to sleep
  • vomiting
Incidence not known
  • Bloated
  • constricted, pinpoint, or small pupils (black part of eye)
  • diarrhea
  • dry mouth
  • excess air or gas in the stomach or intestines
  • feeling of warmth
  • full feeling
  • increase in mucous from the lungs
  • increased need to urinate
  • increased sweating
  • passing gas
  • passing urine more often
  • redness of the face, neck, arms and occasionally, upper chest
  • redness of the skin
  • skin rash
  • stomach cramps

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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