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Glycopyrrolate / Neostigmine Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 12, 2025.

Applies to glycopyrrolate / neostigmine: intravenous solution.

Precautions

Your doctor will check your progress closely while your or your child are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood and urine tests may be needed to check for unwanted effects.

Check with your doctor right away if blurred vision, difficulty with reading, sensitivity of the eyes to light, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you or your child has chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, skin rash, trouble breathing, or unusual tiredness or weakness.

This medicine may make you dizzy, drowsy, or cause blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may make you sweat less, which can cause your body temperature to rise. Be careful when you exercise and during hot weather. You could overheat or get heat stroke. Check with your doctor right away if you or your child has dizziness, fast, shallow breathing, fast, weak heartbeat, headache, muscle cramps, pale, clammy skin, thirst, or extremely high fever or body temperature.

Check with your doctor right away if you or your child have diarrhea or stomach pain. These may be symptoms of a serious stomach or bowel problem (eg, blockage).

This medicine may cause tachycardia. Check with your doctor right away if you have fast, pounding, or irregular heartbeat or pulse.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects

Along with its needed effects, glycopyrrolate/neostigmine 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 while taking glycopyrrolate / neostigmine:

Less common side effects

  • blurred vision
  • change in color vision
  • chest pain, discomfort, or tightness
  • confusion
  • cough
  • decrease in frequency of urination
  • decrease in urine volume
  • difficult and painful urination
  • difficulty in passing urine [dribbling]
  • difficulty seeing at night
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • excitement
  • fast, pounding, or irregular heartbeat or pulse
  • headache
  • hives, itching, skin rash
  • increased sensitivity of eyes to sunlight
  • mental confusion
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • sleeplessness
  • slow or irregular heartbeat
  • sweating
  • thirst
  • trouble breathing
  • trouble sleeping
  • unusual tiredness or weakness

Incidence not known

  • constricted, pinpoint, or small pupils [black part of the eye]
  • diarrhea
  • high fever
  • loss of consciousness
  • no blood pressure or pulse
  • no breathing
  • noisy breathing
  • pale or blue lips, fingernails, or skin
  • rigid muscles
  • seizures
  • sleepiness
  • stopping of the heart
  • unconsciousness

Other side effects

Some side effects of glycopyrrolate / neostigmine 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:

Less common side effects

  • bloated
  • constipation
  • dry skin
  • loss of taste
  • nausea
  • vomiting

Incidence not known

  • difficulty in moving
  • excess air or gas in the stomach or intestines
  • feeling of warmth
  • full feeling
  • increased sweating
  • joint pain
  • muscle pain, stiffness, cramps, or spasms
  • passing gas
  • redness of the face, neck, arms and occasionally, upper chest

For healthcare professionals

Applies to glycopyrrolate / neostigmine: intravenous solution.

General adverse events

The most common adverse effects of glycopyrrolate (glycopyrronium) include xerostomia, urinary hesitancy and retention, blurred vision, and photophobia due to mydriasis, cycloplegia, increased ocular tension, tachycardia, bradycardia, and decreased sweating. The most common adverse effects of neostigmine are bradycardia, nausea, vomiting, blurred vision, and photophobia.[Ref]

Cardiovascular

Glycopyrrolate (glycopyrronium):

Neostigmine:

Dermatologic

Glycopyrrolate (glycopyrronium):

Neostigmine:

Gastrointestinal

Glycopyrrolate (glycopyrronium):

Neostigmine:

Musculoskeletal

Neostigmine:

Genitourinary

Glycopyrrolate (glycopyrronium):

Neostigmine:

Hepatic

Hypersensitivity

Glycopyrrolate (glycopyrronium):

Neostigmine:

Nervous system

Glycopyrrolate (glycopyrronium):

Neostigmine:

Ocular

Glycopyrrolate (glycopyrronium):

Other

Glycopyrrolate (glycopyrronium):

Neostigmine:

Psychiatric

Glycopyrrolate (glycopyrronium):

Neostigmine:

Renal

Respiratory

Glycopyrrolate (glycopyrronium):

Neostigmine:

See also:

References

1. (2023) "Product Information. Prevduo (glycopyrrolate-neostigmine)." Slayback Pharma LLC

2. (2019) "Product Information. Novistig (glycopyrronium-neostigmine)." Boucher & Muir Pty Ltd

3. (2019) "Product Information. Robinul-Neostigmine (glycopyrronium-neostigmine)." Advanz Pharma

Further information

Glycopyrrolate/neostigmine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.