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Prostigmin Bromide

Generic Name: neostigmine (nee o STIG meen)
Brand Name: Bloxiverz, Prostigmin Bromide

What is Prostigmin Bromide (neostigmine)?

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

Neostigmine is used to treat the symptoms of myasthenia gravis.

Neostigmine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Prostigmin Bromide (neostigmine)?

You should not use this medication if you are allergic to neostigmine or pyridostigmine (Mestinon), or if you have a bladder or bowel obstruction, or a serious stomach disorder called peritonitis.

Before taking neostigmine, tell your doctor if you have asthma, kidney disease, slow heartbeats or other heart rhythm disorder, high blood pressure, heart disease, coronary artery disease, an ulcer or other serious stomach disorder, overactive thyroid, or a history of seizures.

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The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it. You may need to take neostigmine at evenly spaced intervals around the clock.

This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need surgery, tell the surgeon ahead of time that you are using neostigmine. You may need to stop using the medicine for a short time.

What should I discuss with my healthcare provider before taking Prostigmin Bromide (neostigmine)?

You should not use this medication if you are allergic to neostigmine or pyridostigmine (Mestinon), or if you have a bladder or bowel obstruction, or a serious stomach disorder called peritonitis.

To make sure you can safely take neostigmine, tell your doctor if you have any of these other conditions:

  • asthma;

  • kidney disease;

  • slow heartbeats or other heart rhythm disorder;

  • high blood pressure, heart disease, coronary artery disease;

  • an ulcer or other serious stomach disorder;

  • overactive thyroid; or

  • a history of seizures.

FDA pregnancy category C. It is not known whether neostigmine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. You should not take neostigmine during late pregnancy.

It is not known whether neostigmine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using neostigmine.

How should I take Prostigmin Bromide (neostigmine)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with food or milk if it upsets your stomach.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it. You may need to take neostigmine at evenly spaced intervals around the clock.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need surgery, tell the surgeon ahead of time that you are using neostigmine. You may need to stop using the medicine for a short time.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, diarrhea, stomach cramps, sweating, blurred vision, drooling, and weak or shallow breathing.

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

What should I avoid while taking Prostigmin Bromide (neostigmine)?

This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Drinking alcohol can increase drowsiness caused by neostigmine.

Prostigmin Bromide (neostigmine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using neostigmine and call your doctor at once if you have any of these serious side effects:

  • extreme muscle weakness;

  • slurred speech, vision problems;

  • feeling like you might pass out;

  • severe stomach cramps or diarrhea;

  • trouble breathing, cough with mucus;

  • fast or slow heart rate;

  • seizure (convulsions); or

  • worsening or no improvement in your symptoms of myasthenia gravis.

Less serious side effects may include:

  • headache, drowsiness;

  • mild nausea, vomiting, gas;

  • urinating more than usual;

  • cold sweat, warmth or tingly feeling; or

  • mild rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Prostigmin Bromide (neostigmine)?

Tell your doctor about all other medicines you use, especially:

  • 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);

  • an antibiotic such as neomycin (Mycifradin, Neo Fradin, Neo Tab), kanamycin (Kantrex), or streptomycin, tobramycin (Nebcin, Tobi);

  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

  • bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

  • cold medicine, allergy medicine, or sleeping pills that contain an antihistamine such as diphenhydramine (Tylenol PM) or doxylamine (Unisom);

  • heart rhythm medication such as quinidine (Quin-G), procainamide (Procan, Pronestyl), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others;

  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine);

  • medicine to treat Alzheimer's dementia, such as donepezil (Aricept), rivastigmine (Exelon), or tacrine (Cognex); or

  • a steroid such as betamethasone (Celestone) or dexamethasone (Cortastat, Dexasone, Solurex, DexPak).

This list is not complete and other drugs may interact with neostigmine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about neostigmine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2013-09-18, 9:35:22 AM.

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