Neostigmine, Injection

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KEY POINTS

• This medicine is given by injection to reverse the effects of some medicines used to relax your muscles during surgery. It may also be used to treat myasthenia gravis. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: cholinergic agonist; acetylcholinesterase inhibitor; antimyasthenic

Generic and brand names: neostigmine methylsulfate, injection; Bloxiverz

What is this medicine used for?

This medicine is given by injection (shots) by your healthcare provider to reverse the effects of some medicines used to relax your muscles during surgery. It may also be used to treat myasthenia gravis.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Asthma
• Heart problems such as an irregular or slow heartbeat
• Seizures
• Thyroid problems
• Intestinal obstruction
• Kidney disease
• Parkinson's disease
• Ulcers
• Trouble urinating

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

The injection form of this medicine will be given by your healthcare provider.

What should I watch out for?

This medicine may cause blurred vision, dizziness, or drowsiness. Do not drive or operate machinery unless you are fully alert and can see clearly.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (Report these to your healthcare provider right away.): Severe nausea, vomiting, or diarrhea; seizures; fast, slow, or irregular heartbeat; chest pain; severe abdominal pain; slurred speech; slow or shallow breathing; worsening muscle weakness or twitching; severe dizziness or fainting; change in balance or trouble walking; vision changes; urination changes.

Other: Headache, mild dizziness, drowsiness, mild stomach pain, increased sweating, muscle cramps, increased drooling, watery eyes.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alzheimer’s disease medicines such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
• Anesthetics such as bupivacaine (Exparel, Marcaine, Sensorcaine), lidocaine (Lidoderm, Xylocaine), and mepivacaine
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), procainamide, and quinidine
• Antibiotics such as amikacin, bacitracin, gentamicin, neomycin (Neo-Fradin), polymyxin B, tetracycline, and tobramycin
• Anticholinergic medicines such as atropine/diphenoxylate (Lomotil), benztropine (Cogentin), dicyclomine (Bentyl), hyoscyamine (HyoMax, Levbid, Levsin), methscopolamine (Pamine), propantheline, and trihexyphenidyl
• Antidepressants such as amitriptyline, desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Pamelor)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril), and meclizine (Dramamine)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa), pimozide (Orap), thioridazine, and trifluoperazine
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Digoxin (Lanoxin)
• Doxepin (Silenor)
• Other myasthenia gravis medicines
• Propranolol (Hemangeol, Inderal, InnoPran)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.