Not medical advice. This information is for educational purposes only. Always consult a qualified doctor or pharmacist before taking any medicine. Neostigmine requires a valid prescription.
Neostigmine
Generic Name: NEOSTIGMINE METHYLSULFATE
Neostigmine Methylsulfate Injection, USP is available in two dosage strengths; 0.5 mg/mL, and 1 mg/mL in 10 mL multiple dose amber glass vials.
Data last updated: 30 March 2026 · Source: openFDA.gov, DailyMed (NLM/NIH)
Common Brand Names in India:
How Does It Work?
Neostigmine also has direct postsynaptic cholinomimetic effects which can be managed clinically by the co-administration of atropine or glycopyrrolate. 12.3 Pharmacokinetics Distribution Protein binding of neostigmine to human serum albumin ranges from 15 to 25%.
Dosage & Administration
- Dosage Should be administered by trained healthcare providers Recommend use of a peripheral nerve stimulator to determine whether neostigmine methylsulfate should be administered and to monitor recovery from neuromuscular blockade .
- Use a peripheral nerve stimulator capable of delivering a train-of-four (TOF) stimulus to evaluate the extent of recovery of neuromuscular function, and to determine the time of the first dose and the need for additional doses of Neostigmine Methylsulfate Injection.
Side Effects
Common Side Effects
Serious Side Effects (seek immediate medical attention)
Warnings & Precautions
- In patients with certain cardiovascular conditions such as coronary artery disease, cardiac arrhythmias or recent acute coronary syndrome, the risk of blood pressure and heart rate complications may be increased.
- Risk of these complications may also be increased in patients with myasthenia gravis.
- To mitigate the risk of neuromuscular dysfunction, consider reducing the dose of neostigmine if recovery from neuromuscular blockade is nearly complete. 5.5 Cholinergic Crisis Overdosage of neostigmine may cause cholinesterase inhibitor toxicity or cholinergic crisis which may be difficult to differentiate from myasthenia crisis since both conditions present with similar symptoms.
Who Should NOT Take This?
- Hypersensitivity to neostigmine ( 4 ) Peritonitis or mechanical obstruction of urinary or intestinal tracts ( 4 )
Drug Interactions
Neostigmine may interact with the following medicines. Always inform your doctor about all medications you are taking.
Storage Instructions
Store at room temperature, away from moisture and heat.
Need a Prescription or Medical Advice?
Consult a qualified doctor before taking Neostigmine. Our verified doctors are available for in-clinic and online consultations.
Other Anaesthetics Medicines
Sources: openFDA.gov · dailymed.nlm.nih.gov · nlm.nih.gov (RxNorm). Information is for educational purposes only. Consult a doctor before use.
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FAQS
Neostigmine – Frequently Asked Questions
Common questions about Neostigmine, its uses, dosage and safety.
Neostigmine is sold in India under brand names such as Bloxiverz, Prevduo, Neostigmine Methylsulfate. You can also find it on online pharmacies like 1mg, Pharmeasy and Apollo Pharmacy.
Neostigmine is a prescription-only (Schedule H) medicine in India. You will need a valid prescription from a registered MBBS / MD doctor to purchase it from a licensed pharmacy.
Common side effects of Neostigmine can include: Nausea, Vomiting, Diarrhea, Headache, Dizziness, Drowsiness, Dry mouth, Insomnia. Less common but serious side effects can include: Serious, Anaphylaxis. Stop the medicine and contact your doctor immediately if any of these appear.
Neostigmine also has direct postsynaptic cholinomimetic effects which can be managed clinically by the co-administration of atropine or glycopyrrolate. 12.3 Pharmacokinetics Distribution Protein binding of neostigmine to human serum albumin ranges from 15 to 25%.
Neostigmine can interact with: Neostigmine, Methylsulfate, Injection, Certain. Tell your doctor about every medicine, supplement and herbal product you take — including ayurvedic and homeopathy preparations — before starting Neostigmine.
Indian guidelines often recommend lower starting doses of Neostigmine for patients above 60-65, since kidney and liver function decline with age. A doctor should review the dose, especially if the patient already takes BP, sugar or heart medicines.
Pregnancy safety of Neostigmine depends on the trimester and individual case. Indian gynaecologists usually avoid Category C/D drugs unless benefit clearly outweighs risk. Speak to your obstetrician before taking Neostigmine during pregnancy or while planning conception.
Prices in India typically range from ₹30 – ₹500 per strip / vial depending on brand. Generic versions tend to cost 30-60% less than branded ones, and Jan Aushadhi outlets often stock the lowest-priced equivalents. Check 1mg or Pharmeasy for live MRP.
If you remember within a few hours of the missed dose, take it. If it is nearly time for the next dose, skip the missed one — never double up. Frequent missed doses reduce Neostigmine's effectiveness, so consider setting a reminder or speaking to your doctor about a simpler schedule.
You can book an in-person or online consultation with a verified Indian specialist on Zospital — visit the doctor directory at https://zospital.com/doctor to find one near you.
Medical Disclaimer
The content provided on Zospital is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If you think you may have a medical emergency, call your doctor or emergency services immediately.