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Neostigmine Dosage

Medically reviewed by Drugs.com. Last updated on Oct 3, 2023.

Applies to the following strengths: 0.5 mg/mL; 1 mg/mL; 15 mg; 0.25 mg/mL

Usual Adult Dose for Reversal of Neuromuscular Blockade

Initial dose: 0.03 to 0.07 mg/kg IV over a period of at least 1 minute
Maximum dose: 0.07 mg/kg IV or up to a total of 5 mg IV, whichever is less

Comments:


NOTE:
a) Reversal of NMBAs with shorter half-lives (e.g., rocuronium)
or
b) When the first twitch response to the TOF stimulus is substantially greater than 10% of baseline or when a second twitch is present.
a) NMBAs with longer half-lives (e.g., vecuronium, pancuronium)
or
b) When the first twitch response is relatively weak (i.e., not substantially greater than 10% of baseline)
or
c) There is need for more rapid recovery.

Use: For the reversal of the effects of non-depolarizing neuromuscular blocking agents (NMBAs) after surgery

Usual Pediatric Dose for Reversal of Neuromuscular Blockade

Initial dose: 0.03 to 0.07 mg/kg IV over a period of at least 1 minute
Maximum dose: 0.07 mg/kg IV or up to a total of 5 mg IV, whichever is less

Comments:


NOTE:
a) Reversal of NMBAs with shorter half-lives (e.g., rocuronium)
or
b) When the first twitch response to the TOF stimulus is substantially greater than 10% of baseline or when a second twitch is present.
a) NMBAs with longer half-lives (e.g., vecuronium, pancuronium)
or
b) When the first twitch response is relatively weak (i.e., not substantially greater than 10% of baseline)
or
c) There is need for more rapid recovery.

Use: For the reversal of the effects of non-depolarizing neuromuscular blocking agents (NMBAs) after surgery

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Precautions

CONTRAINDICATIONS:

with peritonitis or mechanical obstruction of the intestinal or urinary tract.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.