Neostigmine methylsulfate

 Neostigmine in solution for injection
 Neostigmine - a synthetic drug with strong reversible anticholinesterase activity, used to treat nervous system diseases.

Pharmacological action

The active ingredient is a synthetic anticholinesterase neostigmine substance contributes to the accumulation and strengthening the action of acetylcholine in the tissues and organs, as well as the restoration of neuromuscular conduction.

As a result of neostigmine increased secretion of saliva, sweat and the bronchial glands, increasing the tone of smooth muscles of the intestine, reduces intraocular pressure. In addition, according to the instructions Neostigmine tones skeletal muscles and cause bronchospasm.

Product form

Neostigmine produced in the form:

  • Injectable solutions containing 0, 5 mg of active ingredient in 1 ml, in a 1 ml ampoule;
  • White tablets containing 15 mg of active material, 20 pieces in a package.

For children Neostigmine produce a pinkish cream-colored granules for oral suspension at 60 g in 150 ml vials.

The closest analogues of neostigmine on the mechanism of action of drugs are Amiridin, Armin, Ubretid, deoxypeganine hydrochloride oksazil, Neiromidin.

Indications for use of neostigmine

 Neostigmine in the tablets
 According to the instructions Neostigmine is used to treat:

  • Myasthenia gravis;
  • Paralysis;
  • Open-angle glaucoma;
  • Atrophy of the optic nerve;
  • Movement disorders caused by brain injuries;
  • Neuritis;
  • Aton gastrointestinal tract and bladder.

Furthermore, the use of neostigmine effectively:

  • The recovery period after suffering polio, meningitis, encephalitis;
  • To eliminate residual defects neuromuscular non-depolarizing muscle relaxants;
  • In rare cases - when the weakness of labor.


Neostigmine is contraindicated according to the instructions to apply at:

  • Epilepsy;
  • Bradycardia;
  • Angina;
  • Advanced atherosclerosis;
  • Gastric ulcer and 12 duodenal ulcer;
  • Mechanical obstruction of the gastrointestinal tract and urinary tract infections;
  • Intoxication impaired children;
  • Coronary heart disease;
  • Arrhythmia;
  • Bronchial asthma;
  • Thyrotoxicosis;
  • Peritonitis;
  • Prostatic hypertrophy;
  • Hypersensitivity to the components of neostigmine.

Furthermore, the use of neostigmine is contraindicated during the acute infectious diseases, pregnancy and lactation.

Dosing neostigmine

As a rule, on the testimony of Neostigmine take half an hour before meals for one tablet up to three times a day.

Neostigmine For children it is recommended to apply in a dosage form of granules, for which they are previously dissolved in 100 ml of water. In 5 ml of the resulting solution contains 1 mg active compound. The dosage depends on age:

  • Children up to 10 years - for each year of life to 1 mg per day;
  • Children over 10 years - no more than 10 mg of neostigmine per day.

According to the testimony Neostigmine subcutaneously administered several times a day, the maximum single dose should not exceed 2 mg. Most of the daily dose is recommended during the day, which accounts for the highest degree of fatigue. The average duration of treatment is thirty days.

In myasthenia prescribed one tablet a day or neostigmine at 0, 5 mg intravenously. The treatment is usually long, during which it is recommended to change the route of administration. In the treatment of myasthenia effectively conduct complex treatment together with corticosteroids, aldosterone antagonists and anabolic hormones.

For prophylaxis in postoperative atony of the bladder and bowel Neostigmine used subcutaneously or intravenously at 0, 25 mg every 4-6 hours for 3-5 days. For the treatment of urinary retention is recommended to introduce 5 injections of 0, 5 mg at intervals of three hours.

Neostigmine Review effective in reducing intraocular pressure, which instill 1-2 drops of 0, 5% solution in the conjunctival sac to four times per day.

Inside Neostigmine take the weakness of the labor of 3 mg up to six times a day at intervals of 40 minutes. Spacing is the subcutaneous one hour, it should be administered 1 ml of 0 05% solution 1-2 times in combination with a solution of atropine sulphate.

In the application of neostigmine as an antidote is administered muscle relaxants 0, 5-2 mg intravenously slowly.

Side effects of neostigmine

In the opinion of Neostigmine can cause significant side effects, which appear as:

  • Vomiting, hypersalivation, spastic contraction of intestinal peristalsis, flatulence, nausea, diarrhea;
  • Skeletal muscle spasms, tremors, muscle twitching, including language, dysarthria, convulsions, arthralgia;
  • Excessive sweating;
  • Loss of consciousness, dizziness, headache, weakness, drowsiness;
  • Frequent urination;
  • Blurred vision, cramps;
  • Respiratory depression, dyspnea, bronchospasm;
  • Bradycardia or tachycardia, nonspecific ECG changes, arrhythmias, nodal rhythm, AV block, cardiac arrest.

The decrease in blood pressure occurs most frequently when administered parenterally. Allergic reactions are manifested in the application of neostigmine reviews, usually manifest as rash, anaphylaxis, flushing of the face and itching.

The main symptoms of neostigmine overdose of instruction include:

  • Bradycardia;
  • Lowering blood pressure;
  • Cramps;
  • Nausea;
  • Frequent urination;
  • The gradual development of general weakness;
  • Diarrhea;
  • Hypersalivation;
  • Bronchospasm;
  • Increased peristalsis;
  • Twitching of the muscles of the tongue and skeletal muscles.

storage conditions

According to the testimony Neostigmine available on medical prescription. Shelf life of pellets - 24 months, vials - 36 months, tablets - 5 years.