Neostigmine
Also known as: Prostigmin, Robinul-Neostigmine
This medication is used to help diagnose or treat a condition called **myasthenia gravis** (a disease causing severe muscle weakness), or to reverse certain muscle relaxants used during anesthesia. * **Watch closely for side effects:** If your pet begins drooling excessively, vomiting, having diarrhea, or showing signs of breathing difficulty or severe weakness, contact your veterinarian **immediately**. * This drug can cause a sudden drop in heart rate, so it is usually given in the clinic where your pet can be closely monitored. * Do not give any other medications without consulting your vet, as many drugs can interact with neostigmine.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Diagnosis of myasthenia gravis / Antagonism of non-depolarizing neuromuscular block
- Diagnosis of myasthenia gravis / Antagonism of non-depolarizing neuromuscular block
How it is given
Possible side effects
- Nausea and vomiting
- Increased salivation (ptyalism)
- Diarrhoea
- Muscle fasciculations and cramps
- Weakness and paralysis (with overdose)
- Severe bradyarrhythmias or asystole
- Miosis and nystagmus
- Hypotension
- Bronchoconstriction and increased bronchial secretions
Cautions & contraindications
- Mechanical gastrointestinal obstruction
- Mechanical urinary tract obstruction
- Peritonitis
- Use with **extreme caution** in patients with: * **Bronchial disease** (especially feline asthma) * **Bradycardia** and other arrhythmias * **Hypotension** * **Renal impairment** * **Epilepsy** > Always have **atropine** (0.05 mg/kg IV) available for immediate administration when using neostigmine to diagnose myasthenia gravis.
Drug interactions
- Aminoglycosides: May antagonize the neuromuscular effects of neostigmine
- Clindamycin: May antagonize the neuromuscular effects of neostigmine
- Halogenated inhalational anaesthetics: May antagonize the neuromuscular effects of neostigmine
- Quinine and related compounds: May increase clinical severity of myasthenia gravis and reduce neostigmine effectiveness
- Beta-blockers: May reduce effectiveness in myasthenia gravis; concurrent use may result in severe bradycardia
- Suxamethonium: Neostigmine inhibits its metabolism, prolonging and enhancing its clinical effect (combined use not recommended)
- Non-depolarizing muscle relaxants: Neostigmine antagonizes their effect (therapeutic use)
- Atropine: Antagonizes the muscarinic effects of neostigmine (used therapeutically to manage side effects)
Frequently asked questions
What is Neostigmine used for in pets?
This medication is used to help diagnose or treat a condition called **myasthenia gravis** (a disease causing severe muscle weakness), or to reverse certain muscle relaxants used during anesthesia. * **Watch closely for side effects:** If your pet begins drooling excessively, vomiting, having diarrhea, or showing signs of breathing difficulty or severe weakness, contact your veterinarian **immediately**. * This drug can cause a sudden drop in heart rate, so it is usually given in the clinic where your pet can be closely monitored. * Do not give any other medications without consulting your vet, as many drugs can interact with neostigmine.
Is Neostigmine safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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