NEOSTIGMINE methylsulfate, 1mg/ml, 5ml, amp.

STD DINJNEOS1A-

Valid Article

The product is supplied (and stored) sterile, it must remain sterile until its use. Sterile = state of being free from all living microorganisms.
20 - Muscle relaxants (peripherally-acting) and cholinesterase inhibitors
Classification of the medicines in groups and subgroups according to their therapeutic use. The classification used by MSF is based on the WHO Model List of Essential Medicines.
N07AA01
Anatomical Therapeutic Chemical Classification according to WHOCC
Thermosensitive codes are defined for storage and transportation temperature requirements of the products.
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OC validations: approved for procurement and use by an OC for international or local orders specifying context and activity in Medical Standard Lists (MSL)

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NEOSTIGMINE

CAUTION!

In case of shortage with 1mg/ml concentration, the 2.5mg/ml concentration (DINJNEOS2A-) is an alternative. To avoid any risk of medication errors (under- or overdosage), contact your OC referent and refer to Instructions for use Neostigmine 2.5mg/ml (LEAFNEOS1E-P) for recommended procedures.

Therapeutic Action

Cholinesterase inhibitor

Antagonist to non-depolarizing neuromuscular blockade

Indications

Reversal of neuromuscular blockade at the end of surgery, prior to emergence from anaesthesia and extubation

Instructions for use

Must be given as IV injection.

Neostigmine should be ordered together with vecuronium, atracarium, or rocuronium.

Simultaneous administration of anticholinergics (atropine sulphate or glycopyrronium bromide) is recommended to antagonise the muscarinic effects of neostigmine (bradycardia, nausea and vomiting).

Precautions for Use

Do not administer to patients with mechanical obstruction of the gastrointestinal or urinary tracts, peritonitis or doubtful bowel viability.

Use with caution in patients with asthma, as the parasympathomimetic action of neostigmine may cause bronchoconstriction.

Do not use in combination with depolarising muscle relaxants (e.g. suxamethonium), as neuromuscular blockade may be potentiated.

Reversal of non-depolarizing muscle relaxants (vecuronium, atracurium, rocuronium) with neostigmine should be monitored using a peripheral nerve stimulator. No reversal agents should be administered if the train-of-four is 0-1, as neostigmine is ineffective in reversing deep levels of neuromuscular blockade.

Storage

Below 25ºC - Protect from sunlight