Generic Name: physostigmine (FYE so STIG meen)
Brand Name: Antilirium
What is physostigmine?
Physostigmine affects chemicals in the body that control the signals sent from the nervous system to the muscles to activate muscle movement.
Physostigmine is used to reverse the effects of certain drugs or substances that interfere with this nerve-muscle communication. Such substances include atropine, scopolamine, belladonna, antihistamines, some antidepressants, and other anticholinergic (AN tye KOE lin ER jik) drugs.
Physostigmine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about physostigmine?
In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.
What should I discuss with my healthcare provider before receiving physostigmine?
You should not be treated with physostigmine if you are allergic to it, or if you have:
bladder obstruction or other urination problems;
a blockage in your digestive tract (stomach or intestines);
heart disease; or
gangrene (damaged skin and muscle tissue caused by infection or lack of blood supply).
If possible before you receive physostigmine, tell your doctor if:
you have a sulfite allergy;
you have recently taken Ultracet (acetaminophen with tramadol); or
you regularly take bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo, and others).
In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.
How is physostigmine given?
Physostigmine is injected into a muscle or into a vein through an IV. A healthcare provider will give you this injection.
When injected into a vein, physostigmine must be given slowly.
Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving physostigmine.
You may need repeat doses of this medicine, depending on how your body responds to it. Your doctor will determine how long to treat you with physostigmine.
What happens if I miss a dose?
Because you will receive physostigmine in a clinical setting, you are not likely to miss a dose.
What happens if I overdose?
Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid after receiving physostigmine?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Physostigmine side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers right away if you have:
increased urination or bowel movements;
severe or worsening nausea or vomiting;
blurred vision; or
excessive saliva in your mouth.
Common side effects may include:
increased salivation; or
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.
Physostigmine dosing information
Usual Adult Dose for Anticholinergic Syndrome:
Post anesthesia care:
Initial dose: 0.5 to 1 mg, IM or slow IV, at no more than 1 mg/minute
-May repeat dose at 10 to 30 minute intervals if desired response is not obtained
Overdose of drugs that cause anticholinergic syndrome:
2 mg, IM or slow IV, at no more than 1 mg/minute
-May repeat dose if life threatening signs (e.g. arrhythmia, convulsions, coma) occur
Usual Pediatric Dose for Anticholinergic Syndrome:
0.02 mg/kg, IM or slow IV, at no more than 0.5 mg/minute
-May repeat dose at 5 to 10 minute intervals if toxic effects persist (and no cholinergic effects) until a therapeutic effect is obtained.
Maximum dose: 2 mg
What other drugs will affect physostigmine?
Other drugs may interact with physostigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
See also: Side effects (in more detail)
More about physostigmine
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
- En Español
- 0 Reviews – Add your own review/rating
- Drug class: antidotes
Other brands: Antilirium
Related treatment guides
Where can I get more information?
- Your doctor can provide more information about physostigmine.
- 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: 1.01.
Date modified: September 05, 2017
Last reviewed: April 10, 2017