Composition
lnj 0.5 mg/2.5 mg: Neostigmine methylsulphate 0.5 mg/2.5 mg; amp.
Indications & Dosage
Treatment of myasthenia gravis: BY SC INJ, OR BY IM INJ: Adult: 1-2.5 mg, dose repeated at suitable intervals throughout the day (usual total daily dose 5-20 mg). Children: Neonate: 150 mcg/kg every 6-8 hr, 30 minutes before feeds, increased to max 300 mcg/kg every 4 hr, if necessary; 1 month-12 yrs: 200-500 mcg repeated at suitable intervals throughout the day; 12-18 yrs: 1-2.5 mg repeated at suitable intervals throughout the day. Reversal of non-depolarizing (competitive) neuromuscular blockade: BY IV INJ: Adult: 2.5 mg (max. per dose 5 mg), repeated if necessary after or with glycopyrronium or atropine, to be given over 1 minute. Children: Neonate: 50 mcg/kg. after or with glycopyrronium or atropine IV injection over 1 minute; a further dose of 25 mcg/kg may be re-quired; 1 month-12 yrs: 50 mcg/kg (max 2.5 mg) after or with glycopyrronium or atropine IV injection over 1 minute; a further dose of 25 mcg/kg may be required; 12-18 yrs: 50 mcg/kg (max 2.5 mg) after or with glycopyrronium or atropine IV injection over 1 minute; a further dose of 25 mcg/ kg (max 2.5 mg) may be required. Paralytic ileus, post-operative distension: BY SC INJ, OR BY IM INJ: Adult: 0.5-2.5 mg, repeated if necessary. Post-operative urinary retention: BY SC INJ, OR BY IM INJ: Adult: 0.5- 2.5 mg, repeated if necessary. Bladder tony: BY SC INJ, OR BY IM INJ: Adult: Prevention: 0.25 mg every 4-6 hr for 2-3 days. Treatment: 0.5-1 mg every 3 hr for 5 doses after bladder has emptied.
Administration
Administered by IM or SC, or slowly IV
Stability
Stored at room temperature and protect from light, freezing and temperatures of 40 degree centigrade or more
Contraindications
Intestinal or urinary obstruction.
Precautions
Arrhythmias, asthma (extreme caution), cardiac disease, renal impairment (reduce dose), vagotonia, epilepsy, Parkinsonism, bradycardia, hyperthyroidism, hypotension, peptic ulceration, recent myocardial infarction. Glycopyrronium or atropine should also be given when reversing neuromuscular blockade
Interactions
Cyclopropane or halothane anaesthesia. Depo-larising muscle relaxants.
Pregnancy
Caution advised or avoid
Lactation
Contraindicated or avoid
Side Effects
Abdominal cramps, diarrhoea, increased salivation, nausea