Neostigmine

Neostigmine

3-Trimethylammoniumphenyl N, N-dimethylcarbamate

Eustigmin, Eustigmine, Vagostigmin

3-[(dimethylcarbamoyl)oxy]-N,N,N-trimethylanilinium

• Poorly absorbed from the gastrointestinal tract following oral administration
• Metabolized by microsomal enzymes in the liver.
• Does not cross BBB

Neostigmine is a cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. 

• Total daily dose is 75-300 mg in divided doses orally for myasthenia.
• 50-70 mcg/kg by IV injection over 60 seconds 
•  Instill 1-2 drops of 0.5% solution into the eyes 1-4 times daily for glaucoma.

Myasthenia gravis, Paralytic ileus and postoperative urinary retention, Reversal of neuromuscular blockade.

Nausea and vomiting increased salivation and sweating, abdominal cramps, allergic reactions, diarrhea, rash, bradycardia, hypotension.

Effects may be reduced by quinine, chloroquine, hydroxychloroquine, quinidine, propafenone, procainamide, lithium, β-blockers. 

Pregnancy, Lactation

Protect from light. Store at 15-30°C. Do not freeze. 

Molecular weight

223.294

Molecular formula

C12H19N2O2

CAS number

59-99-4

Precautions

Frequently assess muscle strength and function in patient with myasthenia gravis or patient recovering from non depolarizing neuromuscular blocking agent.