Drug reference

Neostigmine

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1210

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Treatment of myasthenia gravis ▶BY MOUTH ▶Adult: Initially 15–30 mg, dose repeated at suitable intervals throughout the day, total daily dose 75–300 mg, the maximum that most patients can tolerate is 180 mg daily ▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Adult: 1–2.5 mg, dose repeated at suitable intervals throughout the day (usual total daily dose 5–20 mg) Reversal of non-depolarising (competitive) neuromuscular blockade ▶BY INTRAVENOUS INJECTION ▶Adult: 2.5 mg (max. per dose 5 mg), repeated if necessary after or with glycopyrronium or atropine, to be given over 1 minute

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Cautions

▶With intravenous use Glycopyrronium or atropine should also be given when reversing neuromuscular blockade

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Safety

Interactions

→Appendix 1: neostigmine

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Side Effects

▶With parenteral use Intestinal hypermotility. muscle spasms

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Renal Impairment

Dose adjustments May need dose reduction.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral solution Solution for injection ▶Neostigmine (Non-proprietary) Neostigmine metilsulfate 2.5 mg per 1 ml Neostigmine 2.5mg/1ml solution for injection ampoules | 10 ampoule P £7.50–£7.51 DT = £7.51 Tablet ▶Neostigmine (Non-proprietary) Neostigmine bromide 15 mg Neostigmine 15mg tablets | 140 tablet P £120.52 DT = £120.52 eiiii F above

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Dose text by age group

Adult

Initially 15–30 mg, dose repeated at suitable

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Adult

1–2.5 mg, dose repeated at suitable intervals

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Adult

2.5 mg (max. per dose 5 mg), repeated if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Neostigmine

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1210

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 1210

Cautions

▶With intravenous use Glycopyrronium or atropine should also be given when reversing neuromuscular blockade

PDF page 1210

Safety

Interactions

→Appendix 1: neostigmine

PDF page 1210

Side Effects

▶With parenteral use Intestinal hypermotility. muscle spasms

PDF page 1210

Renal Impairment

Dose adjustments May need dose reduction.

PDF page 1210

Dose and formulations

Medicinal Forms

PDF page 1210

Dose text by age group

Adult

Initially 15–30 mg, dose repeated at suitable

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Adult

1–2.5 mg, dose repeated at suitable intervals

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Adult

2.5 mg (max. per dose 5 mg), repeated if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1210

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.