Prostig
Generic Name
Neostigmine Methylsulfate
Manufacturer
Various (e.g., specific pharmaceutical companies for local markets)
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| prostig 05 mg injection | ৳ 8.00 | N/A |
Description
Overview of the medicine
Prostig 0.5 mg injection contains Neostigmine Methylsulfate, an anticholinesterase agent used to reverse the effects of non-depolarizing neuromuscular blocking agents, treat myasthenia gravis, and alleviate postoperative urinary retention or paralytic ileus.
Uses & Indications
Dosage
Adults
For reversal of neuromuscular block: 0.5-2.5 mg by slow IV injection. Total dose usually not exceeding 5 mg. For myasthenia gravis: 0.5 mg IM/SC, then individualize.
Elderly
Similar to adult dosage, but caution with renal impairment.
Renal_impairment
Dose reduction may be necessary; monitor closely.
How to Take
Administered intravenously (IV), intramuscularly (IM), or subcutaneously (SC) by a healthcare professional. For IV administration, inject slowly.
Mechanism of Action
Neostigmine is a reversible cholinesterase inhibitor. It prevents the breakdown of acetylcholine by acetylcholinesterase, leading to an accumulation of acetylcholine at cholinergic synapses. This increased concentration of acetylcholine enhances cholinergic transmission, particularly at the neuromuscular junction, improving muscle strength.
Pharmacokinetics
Onset
IV: 1-10 minutes, IM: 20-30 minutes, SubQ: 20-30 minutes
Excretion
Primarily excreted in the urine as unchanged drug and metabolites.
Half life
Approximately 0.5-2.5 hours
Absorption
Poorly absorbed from the GI tract after oral administration; administered parenterally for systemic effects. Rapid onset after IV/IM administration.
Metabolism
Primarily metabolized in the liver by microsomal enzymes and hydrolyzed by cholinesterases.
Side Effects
Contraindications
- Hypersensitivity to neostigmine or any excipients
- Mechanical obstruction of the intestinal or urinary tract
- Peritonitis
Drug Interactions
Corticosteroids
May decrease effects of anticholinesterases.
Atropine/Glycopyrrolate
Used to counteract muscarinic side effects.
Non-depolarizing neuromuscular blockers
Antagonizes effects, used for reversal.
Depolarizing neuromuscular blockers (e.g., succinylcholine)
Prolongs block.
Storage
Store below 25°C, protected from light. Do not freeze.
Overdose
Symptoms include cholinergic crisis (nausea, vomiting, diarrhea, abdominal cramps, increased salivation, bradycardia, bronchospasm, muscle weakness). Treatment involves atropine administration and supportive care.
Pregnancy & Lactation
Pregnancy Category C. Use only if clearly needed. Excreted in breast milk in small amounts; use with caution in breastfeeding mothers.
Side Effects
Contraindications
- Hypersensitivity to neostigmine or any excipients
- Mechanical obstruction of the intestinal or urinary tract
- Peritonitis
Drug Interactions
Corticosteroids
May decrease effects of anticholinesterases.
Atropine/Glycopyrrolate
Used to counteract muscarinic side effects.
Non-depolarizing neuromuscular blockers
Antagonizes effects, used for reversal.
Depolarizing neuromuscular blockers (e.g., succinylcholine)
Prolongs block.
Storage
Store below 25°C, protected from light. Do not freeze.
Overdose
Symptoms include cholinergic crisis (nausea, vomiting, diarrhea, abdominal cramps, increased salivation, bradycardia, bronchospasm, muscle weakness). Treatment involves atropine administration and supportive care.
Pregnancy & Lactation
Pregnancy Category C. Use only if clearly needed. Excreted in breast milk in small amounts; use with caution in breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored correctly.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Expired (Generic available)
WHO Essential Medicine
YesClinical Trials
Extensively studied and widely used for decades. Ongoing research may focus on new applications or formulations.
Lab Monitoring
- Monitor heart rate and rhythm
- Monitor blood pressure
- Monitor respiratory function (especially in reversal of neuromuscular block)
- Monitor renal function in patients with impairment.
Doctor Notes
- Ensure atropine or glycopyrrolate is available to counteract muscarinic effects, especially during reversal of neuromuscular block.
- Careful differentiation between myasthenic crisis and cholinergic crisis is vital in myasthenia gravis patients.
Patient Guidelines
- This injection is administered by a healthcare professional.
- Report any unusual symptoms immediately.
- Follow all post-administration instructions from your doctor or nurse.
Missed Dose Advice
As this is an injection administered by a healthcare professional, missed doses are unlikely in a controlled setting. If used for chronic conditions, consult the doctor immediately if a dose is missed.
Driving Precautions
May cause blurred vision or dizziness, especially if muscarinic side effects occur. Patients should be advised not to drive or operate machinery until they know how this medicine affects them.
Lifestyle Advice
- Maintain regular follow-up appointments.
- For myasthenia gravis, adherence to treatment schedule is crucial.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.