What is Neostigmine Methylsulfate: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Neostigmine Methylsulfate overview

BRAND NAMES:

  • Simplist Neostigmine Methylsulfate, Bloxiverz, Bloxiverz Novaplus, PremierPro Rx Neostigmine Methylsulfate

Generic Names:

  • Neostigmine Methylsulfate

Uses:

  • Treats myasthenia gravis. Also reverses the effects of anesthesia.

Therapeutic Classes:

  • Central Nervous System Agent, Immunological Agent, Nondepolarizing Muscle Relaxant Antagonist

Forms:

  • Injectable

How it’s taken:

  • By injection

What is Neostigmine Methylsulfate used for?

Neostigmine Methylsulfate is an anticholinesterase agent used to treat patients with myasthenia gravis when oral therapy cannot be used. It is also used for the prevention and treatment of postoperative distention and urinary retention after mechanical obstruction has been excluded. It works by increasing movement of the muscles in the body.

What form(s) does Neostigmine Methylsulfate come in

  • Injectable

What are common Neostigmine Methylsulfate doses?

  • Vial 10ML of 10MG/10ML

Common Neostigmine Methylsulfate prescriptions

  • Neostigmine Methylsulfate
    3ml of 3mg/3ml syringe

  • Neostigmine Methylsulfate
    10ml of 10mg/10ml vial

  • Neostigmine Methylsulfate
    10ml of 1mg/ml vial

  • Neostigmine Methylsulfate
    10ml of 5mg/10ml vial

How to take Neostigmine Methylsulfate

  • Injection routeYour doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, or into a vein.

  • Injection routeA nurse or other health provider will give you this medicine.

  • Injection routeYour doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, or into a vein.

  • Injection routeA nurse or other health provider will give you this medicine.

What to do if you miss a dose of Neostigmine Methylsulfate

Neostigmine Methylsulfate contraindications

  • You should not receive this medicine if you have had an allergic reaction to neostigmine, or if you have an intestine or urinary blockage, or swelling of the lining of your abdomen.

Neostigmine Methylsulfate warnings

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney or liver disease, myasthenia gravis (severe muscle weakness), asthma, seizures, an overactive thyroid, or stomach problems.

  • This medicine may cause your heartbeat to slow. Tell your doctor if you have heart disease, heart rhythm problems, or low blood pressure. You may have a higher risk if you have these heart problems.

  • Lightheadedness or fainting

  • Twitching or muscle movements you cannot control, problems with balance or walking

Neostigmine Methylsulfate interactions

  • Make sure your doctor knows if you are also taking medicine to treat or prevent an infection (such as kanamycin, neomycin, streptomycin), or medicine to treat a heart rhythm problem (such as amiodarone, disopyramide, dofetilide, flecainide, Cordarone®, Norpace®, Tambocor®, Tikosyn®).

  • This medicine may cause your heartbeat to slow. Tell your doctor if you have heart disease, heart rhythm problems, or low blood pressure. You may have a higher risk if you have these heart problems.

Neostigmine Methylsulfate side effects

Serious Side Effects

  • Twitching or muscle movements you cannot control, problems with balance or walking

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

  • Fast, slow, or uneven heartbeat

  • Lightheadedness or fainting

Less Serious Side Effects

  • Nausea, vomiting, diarrhea, stomach pain

  • Drooling, or more saliva than usual

  • Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

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