About neostigmine methylsulfate
Acetylcholinesterase inhibitor
Used for
- Reversal of certain muscle relaxants after surgery
- Treatment of myasthenia gravis
- Prevention or treatment of postoperative bowel or bladder inactivity
Usual adult dose
Varies by use and route. For reversing muscle relaxation, typically 0.03–0.07 mg/kg intravenously, with an antimuscarinic medicine.
Usual dose in children
For reversing muscle relaxation, typically 0.03–0.07 mg/kg intravenously, with an antimuscarinic medicine; specialist dosing required.
Common side effects
- Slow heartbeat or abnormal heart rhythm
- Increased saliva, sweating, or bronchial secretions
- Nausea, vomiting, or abdominal cramps
- Muscle twitching or weakness
Important warnings
- Must be given with monitoring when used to reverse muscle relaxants.
- Can cause severe slowing of the heart and breathing problems.
- Avoid or use cautiously with asthma, intestinal or urinary obstruction, and heart disease.
- Excessive dosing can cause worsening weakness and a cholinergic crisis.
Pregnancy
Use only when clearly needed; pregnancy-specific risks and benefits should be assessed by a clinician.
Breastfeeding
Information is limited; use requires assessment of benefits and potential infant effects.
Interactions
- Antimuscarinic medicines, such as atropine, alter its effects and may be given alongside it.
- Aminoglycoside antibiotics and some anesthetics can worsen muscle weakness.
- Beta-blockers may increase risk of a slow heart rate.
- Other cholinesterase inhibitors may increase adverse effects.
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 It may be incomplete or out of date.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.