neostigmine methylsulfate

Q: What is neostigmine (Bloxiverz)?

Neostigmine (Bloxiverz) is an injectable medication used after surgery to help you regain movement in muscles that were paralyzed by certain medications called [nondepolarizing neuromuscular blocking agents](https://www.ncbi.nlm.nih.gov/books/NBK538301/) (NMBAs) during surgery. During surgery, the NMBAs paralyze your muscles by blocking a chemical called [acetylcholine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315934/) that helps your muscles contract. Neostigmine (Bloxiverz) helps you regain muscle movement raising the levels of acetylcholine. Your provider will determine the dose of neostigmine (Bloxiverz) based on how you're doing and what medication was used to paralyze your muscles.

Q: What are some side effects of neostigmine (Bloxiverz)?

A potentially serious side effect of neostigmine (Bloxiverz) is that it can slow down your heart rate. Let your provider know before going in for surgery if you have a history of heart problems or a problem with your immune system called [myasthenia gravis](https://www.goodrx.com/conditions/myasthenia-gravis). These conditions can raise your risk of slow heart rate, low blood pressure, and irregular heart rhythm. Your provider might give you other medications before neostigmine (Bloxiverz) to lower these risks. Other side effects of neostigmine (Bloxiverz) can include fast heart rate, dry mouth, nausea, vomiting, throat pain, dizziness, headache, shivering, difficulty sleeping (insomnia), trouble breathing, or itching.

Q: Is neostigmine (Bloxiverz) safe in children?

Neostigmine (Bloxiverz) is FDA approved for children of all ages. This means it has been studied in children and is known to be safe and works well in this group. Your child's provider will determine your child's dose based on things like their body weight and response to the medication. One thing to note is that children are typically more sensitive the effects of this medication so their provider will pay close attention to things like heart rate and blood pressure.

Generic Bloxiverz

Used for Anesthesia

Neostigmine (Bloxiverz) is injected slowly intravenously (into the veins) to reverse the effects of certain medications used to paralyze muscle movement during surgery. It's given by a trained healthcare provider in a hospital or clinic after surgery.

Reviewed by:

Yen Nguyen, PharmD

Kristianne Hannemann, PharmD

Last reviewed on May 24, 2022

What is Neostigmine (Bloxiverz)?

What is Neostigmine (Bloxiverz) used for?

To reverse the effects of certain muscle-paralyzing medications used during surgery

Drug facts

Common Brands	Bloxiverz
Drug Class	Acetylcholinesterase inhibitor
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Bloxiverz

Drug Class

Acetylcholinesterase inhibitor

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Common questions about Neostigmine Methylsulfate

Neostigmine Methylsulfate is an injectable medication used after surgery to help you regain movement in muscles that were paralyzed by certain medications called nondepolarizing neuromuscular blocking agents (NMBAs) during surgery. During surgery, the NMBAs paralyze your muscles by blocking a chemical called acetylcholine that helps your muscles contract. Neostigmine Methylsulfate helps you regain muscle movement raising the levels of acetylcholine. Your provider will determine the dose of Neostigmine Methylsulfate based on how you're doing and what medication was used to paralyze your muscles.

A potentially serious side effect of Neostigmine Methylsulfate is that it can slow down your heart rate. Let your provider know before going in for surgery if you have a history of heart problems or a problem with your immune system called myasthenia gravis. These conditions can raise your risk of slow heart rate, low blood pressure, and irregular heart rhythm. Your provider might give you other medications before Neostigmine Methylsulfate to lower these risks. Other side effects of Neostigmine Methylsulfate can include fast heart rate, dry mouth, nausea, vomiting, throat pain, dizziness, headache, shivering, difficulty sleeping (insomnia), trouble breathing, or itching.

Let your provider know if you're pregnant before going into surgery. There's not enough information to know if Neostigmine Methylsulfate can cause harm to your unborn baby. But medication similar to Neostigmine Methylsulfate have caused mild contractions (uterine irritability) and early (premature) labor when given close to the due date.

Neostigmine Methylsulfate is FDA approved for children of all ages. This means it has been studied in children and is known to be safe and works well in this group. Your child's provider will determine your child's dose based on things like their body weight and response to the medication. One thing to note is that children are typically more sensitive the effects of this medication so their provider will pay close attention to things like heart rate and blood pressure.

You might experience nausea, vomiting, diarrhea, sweating, slow heart rate, or excessive mucus or saliva if you've received too much of Neostigmine Methylsulfate. In serious cases, receiving too much medication can also cause muscle weakness. Let your provider know if you experience any of the symptoms listed and they can provide you with appropriate care or prescribe medications to treat the overdose.

Neostigmine (Bloxiverz) dosage

Typical dosage for Neostigmine (Bloxiverz)

Interactions between Neostigmine (Bloxiverz) and other drugs

Neostigmine (Bloxiverz) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Neostigmine (Bloxiverz). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Amifampridine
Bupropion
Donepezil

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.