Neostigmine

Generic name
Neostigmine
Brand name
ATC Code
N07AA01
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Neostigmine

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

Adults: The elimination half-life after intravenous administration is between 24 and 80 minutes.
Infants 2 - 12 months: the elimination half-life is significantly lower.
[SmPC Neostigmin PANPHARMA]

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Antagonizing non-depolarizing muscle relaxants
  • Intravenous
    • 1 month up to 18 years
      [1]
      • 0.03 mg/kg/dose, as required. Max: 2 mg/dose.
    • Term neonate
      [3]
      • 0.03 mg/kg/dose, as required.
Myasthenia gravis
  • Intramuscular
    • Term neonate
      [1]
      • Initial dose: 0.04 mg/kg/dose, once only.
      • Maintenance dose: adjust the dose depending on the response to 0.01 - 0.04 mg/kg/dose every 4 hours.
      • Directions for administration:

        30 minutes before the nutrition

    • 1 month up to 6 years
      [1]
      • Initial dose: 0.2 mg/day, once only.
      • Maintenance dose: 0.12 - 0.32 mg/kg/day in 6 - 8 doses. Max: 6 mg/day.
      • Directions for administration:

        Alternative: subcutaneous

    • ≥ 6 years
      [1]
      • Initial dose: 0.5 mg/dose, once only.
      • Maintenance dose: 0.12 - 0.32 mg/kg/day in 6 - 8 doses. Max: 6 mg/day.
      • Directions for administration:

        Alternative: subcutaneous

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Always combine with anticholinergic medication (e.g. atropine).

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

PARASYMPATHOMIMETICS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Anticholinesterases
N07AA02

References

  1. Mylan Healthcare B.V, SmPC Prostigmin (RVG 03775) 04-11-2021, www.geneesmiddeleninformatiebank.nl
  2. PANPHARMA GmbH, SmPC Neostigmin Panpharma 0,5 mg/mL Injektionslösung (6222166.00.00), 05/2021
  3. Meakin G, et al., Neostigmine and edrophonium as antagonists of pancuronium in infants and children., Anesthesiology., 1983, 59(4), 316-21

Changes

Therapeutic Drug Monitoring


Overdose