Neostigmine

Peritonitis, mechanical gastrointestinal or urinary tract obstruction.

Patient with bronchial asthma, cardiovascular disease (e.g. bradycardia, cardiac arrhythmia, CAD, recent acute coronary syndrome, recent MI, hypotension), epilepsy, parkinsonism, hyperthyroidism, peptic ulcer disease, vagotonia. Patient who underwent recent intestinal or bladder surgery. Avoid large doses if with megacolon or decreased gastrointestinal motility. If used for the reversal of neuromuscular blockade, avoid use or use with caution in patients with neuromuscular diseases (e.g. myasthenia gravis, muscular dystrophy). Children and elderly. Pregnancy and lactation. Monitoring Parameters Monitor blood pressure, ECG, and heart rate (particularly with IV use).

Significant: Bradycardia, dysrhythmias, hypotension (especially with IV use); hypersensitivity reactions (e.g. anaphylaxis, angioedema, bronchospasm, erythema multiforme, facial swelling, flushing, generalized rash, hypotension, peripheral oedema, pyrexia, urticaria); neuromuscular dysfunction (use of high IV doses). Eye disorders: Lacrimation, miosis, nystagmus. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal cramps, excessive salivation, increased peristalsis (may result in involuntary defecation). General disorders and administration site conditions: General weakness. Musculoskeletal and connective tissue disorders: Muscle cramps, muscle spasms, fasciculations, paralysis. Nervous system disorders: Headache, convulsions, slurred speech, loss of consciousness, coma, restlessness, agitation, fear. Renal and urinary disorders: Urinary frequency. Respiratory, thoracic and mediastinal disorders: Tight chest, wheezing, increased bronchial secretion, respiratory depression. Skin and subcutaneous tissue disorders: Skin rash, hyperhidrosis, diaphoresis.

May increase the risk of adverse effects with corticosteroids (e.g. methylprednisolone). May prolong the effect of depolarising muscle relaxants (e.g. suxamethonium). Decreased effects of non-depolarising muscle relaxants (e.g. gallamine, pancuronium, tubocurarine). Therapeutic effect may be reduced with anticholinergic agents (e.g. atropine). Increased bradycardic effects with β-blockers. Drugs with neuromuscular blocking activity (e.g. aminoglycosides, clindamycin, colistin, cyclopropane, halogenated inhalational anaesthesia) may antagonise the effects of neostigmine. Reduced efficacy with quinine, chloroquine, hydroxychloroquine, lithium, procainamide, propafenone and quinidine.

Neuromuscular Disorder Drugs

N07AA01 - neostigmine ; Belongs to the class of anticholinesterase. Used as parasympathomimetics.
S01EB06 - neostigmine ; Belongs to the class of parasympathomimetics. Used in the treatment of glaucoma and miosis.