Neostigmine
Uses of Neostigmine
Neostigmine is primarily used in the management of myasthenia gravis, a condition that causes muscle weakness and fatigue and falls under the group of cholinesterase inhibitors.
It is also prescribed to reverse the effects of nondepolarizing muscle relaxants used during surgery and for improving muscle contractions in the intestines or bladder when these muscles are not functioning properly after surgery or due to certain conditions.
Side effects of Neostigmine
Nausea and vomiting
Diarrhoea and stomach cramps
Increased saliva, tear, and mucus production
Muscle cramps or weakness
Blurred vision
How Neostigmine works
Neostigmine falls into the category of cholinesterase inhibitors.
Its primary function is to inhibit the enzyme known as acetylcholinesterase. This enzyme is usually responsible for breaking down the neurotransmitter acetylcholine, which helps nerves communicate with muscles. By preventing this breakdown, Neostigmine allows for an accumulation of acetylcholine, which enhances the effectiveness of nerve signals sent to muscles. This results in stronger muscle contractions.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Neostigmine is available for use via oral route in the form of (tablets). It can also be administered, either intramuscularly or subcutaneously (injection) and intravenously (bolus injection or continuous infusion)
Age and Dose Restrictions
This medicine is meant for adults and children above 12 years of age.
Contraindications
Neostigmine is contraindicated in patients with a known hypersensitivity to it. It should not be used in patients with peritonitis or mechanical obstruction of the intestines or urinary tract. Also, its use is not advised in patients who have been given depolarizing muscle relaxants like succinylcholine.
Other Medications to Avoid
Neostigmine may interact with anticholinergic medicines (such as atropine, benztropine), cholinergic medicines (like bethanechol, pilocarpine), muscle relaxants (for example, rocuronium and vecuronium)
Overdose and Missed Dose
An overdose of Neostigmine could result in increased intensity of side effects such as nausea, vomiting, diarrhoea, blurred vision, slowing of the heartbeat, and breathing problems among others. In such cases, inform your doctor immediately.
If you forget to take a dose of Neostigmine, take it as soon as you remember. Do not double up on your dose if it is almost time for the next one.
Management of Side Effects
Most side effects are temporary and usually resolve when you stop taking this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
Drinking plenty of fluids may help manage side effects like nausea and diarrhoea. Ensure your body is well-hydrated.
Resting and avoiding strenuous activity can help manage muscle cramps or weakness.
Use in Driving and Operating Machinery
Neostigmine may affect your ability to drive or operate heavy machinery. Avoid such activities if you feel dizzy, drowsy, or experience blurred vision after taking this medicine.
Use in Pregnancy and Lactation
It is advisable to consult your doctor before using Neostigmine during pregnancy and breastfeeding.
Caution in Other Conditions
Patients with conditions like seizure disorders, asthma, slow heartbeat (bradycardia), active bleeding or peptic ulcers, and kidney or liver disease should exercise caution when taking Neostigmine.
Special Dietary and Lifestyle Recommendations
Stress management techniques like meditation or yoga may help in improving overall health conditions.
Regular check-ups with your doctor are recommended to monitor your health condition while on this medication.
Frequently asked questions
Does Neostigmine have any effect on sleep?
Neostigmine does not directly affect sleep. However, if you notice changes in your sleep pattern while taking this medicine, consult your doctor.
Will Neostigmine affect fertility?
Neostigmine does not affect fertility. However, if you are planning to conceive, please discuss this with your doctor before initiating therapy.
Is it safe to take Neostigmine daily?
Take Neostigmine in the dose and duration as prescribed by your doctor. Follow the prescription instructions carefully.
How much time does Neostigmine take to work?
Neostigmine works differently for different conditions and the onset of action may vary depending on the dosage form and individual patient response.
What is the best time to take Neostigmine?
The best time to take Neostigmine would be as prescribed by your doctor, based on your medical condition and response to therapy.
What is the duration of treatment with Neostigmine?
The duration of treatment with Neostigmine varies depending on the condition being managed and the individual patient response. It should be taken for the entire duration as prescribed by your doctor.
Is Neostigmine available over the counter, or do I need a prescription?
Neostigmine is a prescription medicine. It is not available over the counter and should be used under medical supervision.
Neostigmine in other salts
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