Neostigmine
Neostigmine is a parasympathomimetic medication that acts as a reversible acetylcholinesterase inhibitor. By preventing the breakdown of acetylcholine, it increases the concentration of the neurotransmitter at the neuromuscular junction, facilitating muscle contraction and reversing muscle relaxants used during anesthesia.
Dosage by Body Weight
Dosage must be strictly individualized. For surgical reversal of neuromuscular blockade, it is administered intravenously by healthcare professionals, typically paired with an anticholinergic agent (such as glycopyrrolate or atropine) to prevent bradycardia. For myasthenia gravis, oral dosing is titrated based on patient response.
- Body Weight
- Below 5 kg
- Dose
- 0.03 to 0.07 mg/kg intravenously
- Frequency
- Single dose under clinical monitoring
- Tracking Notes
- Must be co-administered with an anticholinergic agent to mitigate cholinergic side effects. Administered by professionals only.
- Body Weight
- 5-7 kg
- Dose
- 0.15 mg to 0.49 mg intravenously
- Frequency
- Single dose under clinical monitoring
- Tracking Notes
- Calculated based on 0.03-0.07 mg/kg. Requires continuous cardiac monitoring.
- Body Weight
- 8-10 kg
- Dose
- 0.24 mg to 0.7 mg intravenously
- Frequency
- Single dose under clinical monitoring
- Tracking Notes
- Ensure atropine or glycopyrrolate is available and administered to manage bradycardia.
- Body Weight
- 11-15 kg
- Dose
- 0.33 mg to 1.05 mg intravenously
- Frequency
- Single dose under clinical monitoring
- Tracking Notes
- Dose titrated to response using a peripheral nerve stimulator.
- Body Weight
- 16-20 kg
- Dose
- 0.48 mg to 1.4 mg intravenously
- Frequency
- Single dose under clinical monitoring
- Tracking Notes
- Ensure adequate recovery of neuromuscular function is verified before extubation.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | 0.03 to 0.07 mg/kg intravenously | Single dose under clinical monitoring | Must be co-administered with an anticholinergic agent to mitigate cholinergic side effects. Administered by professionals only. |
| 5-7 kg | 0.15 mg to 0.49 mg intravenously | Single dose under clinical monitoring | Calculated based on 0.03-0.07 mg/kg. Requires continuous cardiac monitoring. |
| 8-10 kg | 0.24 mg to 0.7 mg intravenously | Single dose under clinical monitoring | Ensure atropine or glycopyrrolate is available and administered to manage bradycardia. |
| 11-15 kg | 0.33 mg to 1.05 mg intravenously | Single dose under clinical monitoring | Dose titrated to response using a peripheral nerve stimulator. |
| 16-20 kg | 0.48 mg to 1.4 mg intravenously | Single dose under clinical monitoring | Ensure adequate recovery of neuromuscular function is verified before extubation. |
Formulation
Purpose
Reversal of non-depolarizing neuromuscular blockade after surgery, treatment of myasthenia gravis, and prevention or treatment of postoperative abdominal distention and urinary retention.
Generic Name
NeostigmineBranded Drug Names
Neostigmine is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
Yes. This medicine should be supplied or used only according to applicable prescription and regulatory requirements.