About neostigmine methylsulfate
Acetylcholinesterase inhibitor
Used for
- Treatment of myasthenia gravis.
- Reversal of certain muscle relaxants after surgery; usually given by injection.
Usual adult dose
Myasthenia gravis: typically 15–30 mg by mouth every 3–4 hours while awake; dosing is individualized.
Usual dose in children
Not routinely used by mouth in children; specialist-directed dosing is required.
Common side effects
- Abdominal cramps, diarrhea, nausea, and increased saliva.
- Slow heartbeat or fainting.
- Muscle twitching, cramps, or weakness.
- Increased urination and sweating.
Important warnings
- Excess dosing can cause severe weakness, breathing difficulty, and a medical emergency.
- Use cautiously with asthma, heart rhythm problems, low blood pressure, or bowel or urinary blockage.
- Tablets are not interchangeable with injectable neostigmine; formulations and uses differ.
Pregnancy
Use only when clearly needed; pregnancy data are limited, and myasthenia gravis itself requires careful management.
Breastfeeding
Limited information is available; discuss use with a clinician, especially for newborn or premature infants.
Interactions
- Other cholinergic medicines can increase side effects.
- Antimuscarinic medicines, such as atropine, may oppose its effects.
- Some antibiotics, including aminoglycosides, can worsen muscle weakness.
- Beta-blockers may increase risk of a slow heartbeat.
AI-generated from general medical knowledge, not from this product's official leaflet. It may be incomplete or out of date. Not medical advice — ask a pharmacist or doctor before making any decision.