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Neostigmine

Latest prescription information about Neostigmine. Learn how to pronounce the drug’s name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, its storage instructions and warnings if any when taken during pregnancy. Also listed are the International and Indian trade name(s) of the drug and its price list.
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Generic Name : Neostigmine
Pronunciation : NEE-oh-STIG-meen
Therapeutic Classification : Cholinergic Agents
ICD Code : Y51.1
Trade Name(s): 
India- Beemine Amp, Myostigmin Amp, Neostigmine Inj, Prostigmin Inj, Prostigmin Tab, Stimin Amp, Stimin-G Amp, Tilstigmin Inj , Tilstigmin Tab.
International- Prostigmin.
Why it is prescribed (Indications) : This medication is a cholinesterase inhibitor, prescribed for Myasthenia Gravis. It inhibits the chemicals, which brings non-communication between the nervous and the muscular system. Neostigmine enhances the muscular movements in case of Myasthenia Gravis condition.  
When it is not to be taken (Contraindications): It is not prescribed in patients with mechanical intestinal obstruction or urinary tract obstruction, peritonitis; known hypersensitivity.

Pregnancy Category :

A B C D X
Category C : Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Dosage & When it is to be taken : Oral/IV: The recommended dose is 15 mg to 375 mg per day in divided doses.
How it should be taken : It comes as a tablet to take by mouth, and solution for injection.
Warnings and Precautions : 
* Caution should be exercised in patients with epilepsy, bronchial asthma, slow heart beat, recent heart attack, low blood pressure, over activity or irritability of the vagus nerve, increased level of thyroid hormone, recent intestinal or bladder surgery, kidney impairment, abnormal heart rhythm, peptic ulcer, during pregnancy and breastfeeding.
* Inform the doctor if you experience symptoms like muscular weakness and respiratory paralysis. Clear difference need to be made between the symptoms caused due to excess dosage of anticholinesterase drugs and Myasthenia Gravis condition. Avoid excess dosage
Side Effects : 
Most Common- Increased salivation, sweating, nausea, vomiting, abdominal cramps and diarrhea.
Central Nervous System- Dizziness, convulsions, loss of consciousness, drowsiness, headache, speech disorder and vision changes.
Heart- Abnormal heart rhythm, circulatory arrest, fainting and low blood pressure.
Respiratory- Difficulty in breathing, respiratory depression, respiratory arrest and asthma.
Skin- Rash and hives.
Gastrointestinal - Flatulence and increased peristalsis.
Genitourinary- Increased urinary frequency.
Musculoskeletal - Muscle cramps and joint pain.
Miscellaneous- Excessive sweating, flushing and weakness.
Potentially Fatal- Anaphylaxis.
Other Precautions : 
* Prior to the administration of neostigmine injection, atropine medication is injected in order to avoid allergic reactions.
Storage Conditions : 
Store it at room temperature (15-30°C). Protect from light. Do not freeze.

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Reference  

  • Food and Drug Administration (FDA)
  • National Institutes of Health (NIH)
  • PubMed
  • CIMS
  • Indian Pharma Reference Guide 2012
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