Neostigmine Methylsulphate

Generic Details

Generic Name

Neostigmine Methylsulfate

Other Names

  • Neostigmine Methylnonanoyl Sulfate

Drug Class

  • Cholinesterase Inhibitor

Chemical Formula

C13H22N2O6S

Molecular Weight

334.39 g/mol

Mechanism of Action

  • Neostigmine Methylsulfate acts by inhibiting the enzyme acetylcholinesterase, thereby increasing the levels of acetylcholine at the neuromuscular junction. This results in enhanced muscle contractions.

Indications

  • Myasthenia Gravis
  • Postoperative Paralytic Ileus
  • Neuromuscular Blockade Reversal

Common Dosage Forms

  • Tablet
  • Injection

Typical Dosage

  • 15-30 mg orally every 3-4 hours as needed for myasthenia gravis

Pediatric Dosage

  • Consult pediatrician for appropriate dosing based on weight and condition

Geriatric Dosage

  • Dosage adjustment may be needed; consult healthcare provider

Side Effects

  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Excessive salivation
  • Bradycardia
  • Dizziness

Contraindications

  • Hypersensitivity to neostigmine
  • Intestinal or urinary tract obstruction
  • Bradycardia
  • Hypotension

Pregnancy Category

  • C - Use with caution, benefits may outweigh risks

Lactation Safety

  • May excrete into breast milk, use caution

Drug Interactions

  • Anticholinergic drugs
  • Atropine
  • Succinylcholine

Overdose Symptoms

  • Excessive salivation
  • Muscle weakness
  • Respiratory distress
  • Bradycardia

Antidote for Overdose

  • Atropine
  • Pralidoxime

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Well absorbed orally
  • Distribution: Distributed widely in the body, including the CNS
  • Metabolism: Metabolized in the liver
  • Excretion: Excreted in urine

Precautions

  • Caution in patients with urinary or intestinal obstruction
  • Monitor for signs of cholinergic crisis

Warnings

  • Avoid abrupt discontinuation in myasthenia gravis patients

Others