Daehan Neostigmine Methylsulfate Injection

Adult administration

For myasthenia gravis, prolongation of respiratory depression due to curare, gastrointestinal dysfunction and post-surgical bowel paralysis, difficulty in urination, neostigmine methylsulfate of 0.25 to 1.0 mg is injected subcutaneously or intramuscularly 1-3 times a day. The dosage for myasthenia gravis should be adjusted according to symptoms, and other indications should also be adjusted according to age and symptoms. For antagonism of the action of non-depolarizing muscle relaxants, 0.5 to 2.0 mg is injected slowly.

This drug is an antagonist of non-depolarizing muscle relaxants, so it should only be used by experienced physicians in medical facilities that can respond to emergencies when injected intravenously. When using an ampule, there is a risk of glass fragments being mixed in, therefore, when cutting the ampule, extra caution should be exercised, especially when administering to children and the elderly. This medicine should not be used in patients with obstruction in the gastrointestinal or urinary tract, those with hypersensitivity to the components of the drug, patients with vagal nerve hypertonia, patients currently on depolarizing muscle relaxants, or in cases of high halothane concentration in the alveoli. Caution should be exercised when administering to patients with bronchial asthma, hyperthyroidism, coronary artery obstruction, bradycardia, peptic ulcers, epilepsy, Parkinson's syndrome, or severe renal impairment, as the effects of the drug may be enhanced or side effects may occur. This drug can cause cholinergic crises such as abdominal pain, diarrhea, sweating, excessive salivation, miosis, and fasciculations; if these symptoms occur, administration should be stopped immediately and appropriate treatment should be sought. Furthermore, cardiac arrhythmias may occur, so the heart condition should be closely monitored after administration. This drug can cause crises that worsen myasthenia gravis and respiratory distress, so if symptoms are suspected, prompt differential diagnosis and appropriate management should be undertaken. For patients with bradycardia, medications to increase heart rate should be administered before the drug. Caution should be taken when using calcium channel blockers or beta-blockers as side effects may increase. This drug should not be used in conjunction with depolarizing muscle relaxants, and caution should be exercised regarding interactions when used with cholinergic agents. When used with anticholinergic agents, initial symptoms may be masked, posing a risk of overdose, so it is advisable to avoid this combination if possible. Women who are pregnant or may become pregnant should preferably avoid using this drug. Elderly patients may have reduced bodily functions, so care should be taken to reduce the dosage, etc. In case of overdose, cholinergic crisis symptoms may appear, so administration should be stopped immediately and necessary emergency treatment should be administered. When cutting an ampule, it should be done carefully and slowly injected intravenously to prevent contamination; when injecting into muscle, nerves or blood vessels should be avoided, and if there is pain or abnormal signs, the site should be changed. Also, care should be taken when using with barbiturates.

Serious side effects

Cholinergic crisis (abdominal pain, diarrhea, sweating, excessive salivation, miosis, fasciculations), arrhythmia (ventricular ectopic beats, ventricular tachycardia, atrial fibrillation, cardiac arrest), bradycardia, atrioventricular block, cardiac arrest, bronchospasm, respiratory distress, cyanosis, generalized weakness, severe exacerbation of symptoms, severe allergic reactions (hypersensitivity).

Mild side effects

• Abdominal pain
• diarrhea
• sweating
• excessive salivation
• miosis
• fasciculations
• hypotension
• bradycardia
• tachycardia
• bronchospasm

This drug should be stored in a sealed container that can block light, and it is important to maintain a storage temperature between 1 degree and 30 degrees Celsius at room temperature. Storing it this way will help maintain the drug's effectiveness and prevent deterioration.

Appearance

It is a colorless and transparent liquid.

Package unit

1mL/ampule x 50, 1mL/ampule x 10