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Neostigmine (Oral route)

Pronunciation:

nee-oh-STIG-meen

Brand Names:

  • Prostigmin Bromide

Dosage Forms:

  • Tablet

Classifications:

Therapeutic—

Central Nervous System Agent

Pharmacologic—

Cholinesterase Inhibitor

Uses of This Medicine:

Neostigmine is used to treat a muscle disease called myasthenia gravis. .

This medicine is available only with your doctor's prescription .

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of neostigmine in the pediatric population. Safety and efficacy have not been established .

Older adults—

No information is available on the relationship of age to the effects of neostigmine in geriatric patients .

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Succinylcholine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Intestine blockage (blocked gut or abdomen) or
  • Kidney blockage (blocked urine flow) or
  • Peritonitis (lining of the abdomen is inflamed)—Should not be used in patients with these conditions.
  • Asthma or
  • Bradycardia (slow heartbeat) or
  • Heart attack, recent or
  • Heart rhythm problems or
  • Overactive thyroid or
  • Seizures or
  • Stomach ulcer—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

It is important to keep a daily record of when you take each dose and how long it lasts. This will help your doctor decide if your dose needs to be adjusted .

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For myasthenia gravis:
      • Adults—The usual dose is 15 to 375 milligrams (mg) each day, given in divided doses. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects .

If your symptoms do not improve or if they become worse, check with your doctor .

Side Effects of This Medicine:

Along with its needed effects, a medicine 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 immediately if any of the following side effects occur:

More common
Twitches of the muscle visible under the skin
Incidence not known
Blurred or loss of vision
changes in patterns and rhythms of speech
chest pain or discomfort
confusion
cough
difficult or labored breathing
difficulty in moving
difficulty swallowing
disturbed color perception
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
double vision
fast, pounding, or irregular heartbeat or pulse
halos around lights
hives
irregular, fast or slow, or shallow breathing
itching
lightheadedness, dizziness, or fainting
loss of consciousness
muscle cramps and spasms
muscle pain or stiffness
night blindness
no blood pressure or pulse
noisy breathing
overbright appearance of lights
pain in joints
pale or blue lips, fingernails, or skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
seizures
shortness of breath
skin rash
slow or irregular heartbeat
slurred speech
stopping of heart
sweating
tightness in chest
trouble in speaking
tunnel vision
unconsciousness
unusual tiredness or weakness
wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of Overdose
Constipation
decreased sexual ability
difficult urination
dry mouth
enlarged pupils
muscle weakness

Some side effects 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:

More common
Increased watering of mouth
Incidence not known
Bloated
constricted, pinpoint, or small pupils (black part of eye)
diarrhea
drowsiness
excess air or gas in stomach or intestines
feeling of warmth
full feeling
headache
increase in mucous from lungs
increased need to urinate
increased sweating
nausea
passing gas
passing urine more often
redness of skin
redness of the face, neck, arms and occasionally, upper chest
skin rash
stomach cramps
vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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