A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Neostigmine Side Effects, and Drug Interactions - Neostigmine Methylsulfate (injection)
Neostigmine Side Effects, and Drug Interactions - Neostigmine Methylsulfate (injection)
SIDE EFFECTS
Side effects are generally due to an exaggeration of pharmacological
effects of which salivation and fasciculation are the most common. Bowel
cramps and diarrhea may also occur.
The following additional adverse reactions have been reported following
the use of either neostigmine bromide or neostigmine methylsulfate.
Allergic
Allergic reactions and anaphylaxis.
Neurologic
Dizziness, convulsions, loss of consciousness, drowsiness, headache,
dysarthria, miosis and visual changes.
Cardiovascular
Cardiac arrhythmias (including bradycardia, tachycardia, atrioventricular
block and nodal rhythm) and nonspecific electrocardiogram changes have
been reported, as well as cardiac arrest, syncope and hypotension. These
have been predominantly noted following the use of the injectable form
of neostigmine methylsulfate.
Respiratory
Increased oral, pharyngeal and bronchial secretions, dyspnea, respiratory
depression, respiratory arrest and bronchospasm.
Dermatologic
Rash and urticaria.
Gastrointestinal
Nausea, emesis, flatulence and increased peristalsis.
Genitourinary
Urinary frequency.
Musculoskeletal
Muscle cramps and spasm, arthralgia.
Miscellaneous
Diaphoresis, flushing and weakness.
DRUG INTERACTIONS
Neostigmine Methylsulfate Injection does not antagonize, and may in fact
prolong, the Phase I block of depolarizing muscle relaxants such as succinylcholine
or decamethonium. Certain antibiotics, especially neomycin, streptomycin
and kanamycin, have a mild but definite nondepolarizing blocking action
which may accentuate neuromuscular block. These antibiotics should be
used in the myasthenic patient only when definitely indicated, and then
careful adjustment should be made of the anticholinesterase dosage. Local
and some general anesthetics, antiarrhythmic agents and other drugs that
interfere with neuromuscular transmission should be used cautiously, if
at all, in patients with myasthenia gravis; the dose of neostigmine methylsulfate
may have to be increased accordingly.
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