Neostigmine 0,5 mg
Neostigmine methylsulfate 0.5mg/ml
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1.Composition
Neostigmine methylsulfate 0.5mg/ml
2.Dosage Form
Solution for injection
3.Indication
Myasthenia Gravis, antagonist to non-depolarizing neuromuscular blockade, Paralytic Ileus, Post-operative Urinary Retention; Paroxysmal Supraventricular Tachycardia
4.Dosage Administration
Neostigmine Methylsulfate should be given very slowly by the IV route. A syringe of Atropine Sulfate should always be available to counteract severe cholinergic reactions should they occur.
Myasthenia Gravis
1 – 2.5mg by IM or SC injection at intervals throughout the day, when maximum strength is needed. The usual duration of action of a dose is two to four hours. The total daily dose is usually 5 – 20mg by injection but higher doses may be needed by some patients.
Neonatal Myasthenia Gravis may be treated with 0.1mg Neostigmine intramuscularly initially. Thereafter, the dose must be titrated individually. But is usually 0.05 – 0.25mg IM or 0.03mg/kg IM, every two – four hours. Because of the self-limiting nature of the disease in neonates, the daily dosage should be reduced until the drug can be withdrawn.
Older Children: (Under 12 years of age)
May be given 0.2 – 0.5mg by injection as required. Dosage requirements should be adjusted according to the response of the patient.
Antagonist to Non-depolarizing Neuromuscular Blockade
Reversal of Neuromuscular blockade with Neostigmine should not be attempted unless there is spontaneous recovery from paralysis.
Adults and Children
A single dose of Neostigmine 0.05 – 0.07 mg/kg body-weight and Atropine 0.02 – 0.03 mg/kg body weight, by slow IV injection over one minute is usually adequate for complete reversal of Non-depolarizing Muscle Relaxants within 5 – 15 minutes. The maximum recommended dose of Neostigmine in adults is 5mg and in children 2.5mg.
Atropine and Neostigmine may be given simultaneously, but in patients with Bradycardia, the pulse rate should be increased to 80 per minute with Atropine before administering Neostigmine.
Other Indications
Adults: 0.5 – 2.5mg Neostigmine Methylsulfate by SC or IM injection.
Children: 0.125 – 1mg by injection. Doses may be varied according to the individual needs of the patient.
Elderly: There are no specific dosage recommendations for Neostigmine Methylsulfate in the elderly.
