Neostigmine
- Atc Codes:N07AA01#S01EB06
- CAS Codes:114-80-7#59-99-4#51-60-5
- PHARMGKB ID:114-80-7#59-99-4#51-60-5
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Normastigmin; Belgium: Prostigmine; Bulgaria: Syntostigmin; Cyprus: Neostigmin; Czech Republic: Syntostigmin; France: Prostigmine; Germany: Jorinda, Konstigmin, Neostig, Neostigmin, Sylvemid; Greece: Neostigmine, Normastigmin, Prostigmine; Hungary: Stigmosan; Ireland: Neostigmine; Italy: Intrastigmina, Prostigmina; Lithuania: Syntostigmin; Luxembourg: Prostigmine; Malta: Neostigmine; Netherlands: Neostigmine, Prostigmin; Poland: Polstigminum; Portugal: Intrastigmina, Neostigmine; Romania: Neostigmina; Slovakia: Syntostigmin; Spain: Neostigmina, Prostigmine; Sweden: Neostigmin; UK: Neostigmine.
North America
Canada: Neostigmine, Prostigmin.
Latin America
Argentina: Fadastigmina, Neostigmina; Brazil: Normastig, Prostigmine; Mexico: Prostigmine.
Asia
Japan: Neostigmine, Vagostigmin.
Drug combinations
Neostigmine and Glycopyrrolate
Chemistry
Neostigmine Bromide: C~12~H~19~BrN~2~O~2~. Mw: 303.20. (1) Benzenaminium, 3-[[(dimethylamino)carbonyl]oxy]-N,N,N-trimethyl-, bromide; (2)(m-Hydroxyphenyl)trimethylammonium bromide dimethylcarbamate. CAS-114-80-7; CAS-59-99-4 (neostigmine).
Neostigmine Methylsulfate: C~13~H~22~N~2~O S. Mw: 334.39. Benzenaminium, 3-[[(dimethylamino)carbonyl]oxy]-N,N,N-trimethyl-, methyl sulfate. CAS-51-60-5.
Pharmacologic Category
Parasympathomimetic (Cholinergic) Agents; Acetylcholinesterase Inhibitor. Diagnostic Agents; Myasthenia Gravis. (ATC-Code: N07AA01; S01EB06).
Mechanism of action
Inhibits destruction of acetylcholine by acetylcholinesterase, which facilitates transmission of impulses across myoneural junction.
Therapeutic use
Diagnosis and treatment of myasthenia gravis. Prevention and treatment of postoperative bladder distention and urinary retention. Reversal of effects of nondepolarizing neuromuscular-blocking agents after surgery.
Pregnancy and lactiation implications
Use with caution in pregnancy. Excretion in breast milk unknown (not recommended in nursing women).
Unlabeled use
Contraindications
Hypersensitivity to neostigmine, bromides, or any component of the formulation. Gastrointestinal or genitourinary obstruction.
Warnings and precautions
Anticholinesterase insensitivity can develop for brief or prolonged periods. Overdosage may result in cholinergic crisis. Hypersensitivity reactions might occur. Use with caution in asthma, hyperthyroidism, bradycardia and cardiac arrhythmias, and gastrointestinal disease, including peptic ulcer disease; also in history of seizure disorder. Not generally recommended for use in vagotonia. Does not antagonize and may prolong phase I block of depolarizing muscle relaxants (e.g. succinylcholine).