Neostigmine Methylsulphate Injection

Therapeutic Class: Others

Dosage Forms: Injectables

Brand Name: Neostigmine Injection 0.5 mg/ml

Packaging Available In Alu/PVC Blister

Pack Size: 30x10 Softgels

Best Neostigmine Methylsulphate Injection Manufacturer, Supplier & Exporter In India.

How it works?

Uses of Neostigmine Methylsulphate Injection

Neostigmine Methylsulphate Injection helps muscles work better by stopping an enzyme that breaks down a chemical called acetylcholine. This chemical tells your muscles when to move. By keeping more acetylcholine around, neostigmine helps reverse muscle weakness caused by certain medications used during surgery.

What Neostigmine Methylsulphate Injection Used For

Use What It Helps With
Reversing muscle relaxants after surgery Helps you regain normal muscle movement
Treating myasthenia gravis A condition that causes muscle weakness
Helping with trouble urinating after surgery Makes it easier to pass urine
Treating slow gut movement (paralytic ileus) Helps restart bowel movement
Rare cases of swollen large intestine (Ogilvie’s syndrome) Improves gut function

Dosages administration of Neostigmine Methylsulphate Injection

Dosages Of Neostigmine Methylsulphate Injection

  • Only medical professionals with the necessary training should administer it.
  • To determine the best time and dose, use a peripheral nerve stimulator.
  • Give intravenously over a period of not less than one minute.
  • Until you fully recover, make sure your nostrils are open and that you have enough ventilation.

Adult Dosage Guidelines for

Parameter Recommendation
TOF Monitoring Required: first twitch 10% of baseline
Dose Range 0.03–0.07 mg/kg IV
Injection Rate Slow IV over ≥1 minute
Max Total Dose 0.07 mg/kg or 5 mg, whichever is less
TOF Recovery Target TOF ratio of 0.9 within 10–20 minutes

Dose Selection Criteria

  • 0.03 mg/kg:
    • For short-acting NMBAs (e.g., rocuronium)
    • When the TOF response is strong or a second twitch is present.
  • 0.07 mg/kg:
    • For long-acting NMBAs (e.g., vecuronium, pancuronium)

When TOF response is weak or rapid reversal is needed.

Pediatric Dosage

  • Follow adult dosing guidelines
  • Pediatric patients require similar weight-based doses

Anticholinergic Co-Administration
Agent Timing Route
Atropine sulfate or Glycopyrrolate Prior to or with Neostigmine IV via separate syringe
  • In bradycardia, administer anticholinergic first.

Monitoring & Recovery

  • Continue TOF monitoring post-dose.
  • Do not rely solely on TOF for extubation decisions.
  • Assess:
    • Skeletal muscle tone.
    • Respiratory function.
    • Patient’s clinical condition.

Side effects of Neostigmine Methylsulphate Injection

Side Effect of Neostigmine Methylsulphate Injection.

Nervous System

  • Convulsions, drowsiness, slurred speech (dysarthria)
  • Muscle twitching (fasciculation), loss of consciousness
  • Pupil constriction (miosis), visual disturbances

Cardiovascular

  • Cardiac arrest, arrhythmias (A-V block, nodal rhythm)
  • Low blood pressure (hypotension), fainting (syncope)
  • Nonspecific EKG changes

Respiratory

  • Bronchospasm, increased secretions (oral, pharyngeal, bronchial)
  • Respiratory depression or arrest

Allergic Reactions

  • Rash, hives (urticaria), anaphylaxis

Gastrointestinal

  • Cramps, diarrhea, gas (flatulence), increased bowel movement

Miscellaneous

  • Sweating (diaphoresis), flushing

Musculoskeletal

  • Joint pain (arthralgia), cramps, spasms, weakness

Urinary

  • Increased frequency

These effects stem from neostigmine’s role as a cholinesterase inhibitor, which boosts acetylcholine levels—great for reversing muscle relaxants, but it also ramps up parasympathetic activity, hence the wide-ranging side effects.

Precautions of Neostigmine Methylsulphate Injection

Precautions of Neostigmine Methylsulphate Injection:

Risk of Bradycardia
The heart rate may be slowed with neostigmine.

To lower this risk, atropine sulfate or glycopyrrolate pretreatment is advised.

Heart-Related Disorders
Use with caution in patients who have:

Heart disease

Arrhythmias of the heart

Acute coronary syndrome recent

Gravis myasthenia

These patients might be more susceptible to dysrhythmia, bradycardia, or hypotension.

Anticholinergic medications can assist in controlling these side effects.

Intolerance
There could be allergic reactions, including anaphylaxis.

Keep emergency drugs and atropine close at hand.

Neuromuscular Impairment
When muscle recovery is almost finished, high dosages may result in dysfunction.

Adapt the dosage to the neuromuscular condition.

Myasthenic Crisis vs. Cholinergic Crisis
Although they both result in extreme muscle weakness, they need different therapies.

To prevent symptoms from getting worse, an accurate diagnosis is essential.

Considerations for Pregnancy and Lactation
Being pregnant
There is no available well-controlled human research.

Low dosages cause no harm, according to animal research.

may result in near-term preterm labor or uterine irritation.

Use only when absolutely necessary.

If a medication enters breast milk during lactation, it is unknown.

Think about

Benefits of breastfeeding

The necessity of treatment for Mom

possible dangers to the baby.

Storage instruction of Neostigmine Methylsulphate Injection

Store at a temperature not exceeding 25°C. Protect from light.

Keep out of reach of children.

 

Packing details of Neostigmine Methylsulphate Injection

10 × 1 ml Ampoules

Neostigmine Methylsulphate Injection  is available as 1 ml in an amber blue dot glass ampoule. Such 10 glass ampoules in a unit carton with a pack insert.

 

F. A. Q

Frequently Asked Questions

Questions are useful tools, they open lines of communication; give us information; improve interactions, facilitate analysis, and many more.

A pharma CMO is a special kind of an organization, offering contract manufacturing services to pharmaceutical companies for various kinds of drug formulations.

Reduce overall costs and time to market :
Contract manufacturers already have the needed infrastructure and technical staff, so working with a CMO or CDMO can decrease the cost of manufacturing your pharmaceutical products.

Scalability and flexible production capacity :
You can produce what you need when you need it without worrying about excess capacity. Additionally, CMOs understand the importance of quality and compliance, so you don't have to sacrifice safety for scalability.

Save on upgrading and maintaining equipment :
If you have your manufacturing facility, you’ll have to pay to upgrade your equipment as technology advances—which can get expensive. A CMO/CDMO’s only function is to make and distribute products, so part of their core business responsibility is to update their equipment whenever needed and perform maintenance.

Ease supply chain issues :
During the pandemic, there were several instances of supply chain issues, including medicine shortages. CMOs are generally better equipped than startups to handle a supply chain crisis.

Bandwidth to focus on core competencies
When your company resources aren’t directly allocated to manufacturing and distribution, you have more time to focus on other tasks, like marketing your new drug, researching, or working on drug discovery.

We have 7+ manufacturing sites with a minimum of WHO GMP certification and other country-specific approvals like NAFDAC approved, PPK Kenya Approved, TFDA Tanzania Approved, EU-GMP Approved.

We have below manufacturing capacity:
For Tablet, Capsule, and soft gel: up to 1 million units per shift
For Syrup: up to 0.05 Million per shift
For Ampoule and Vial: up to 0.1 million units per shift
For Ointment and Cream: up to 0.1 million units per shift
For Suppository: 0.1 Million units per shift

interested? let’s talk.

Contact us directly to receive full information on the product, the formulation, the science behind it, stability data, and more. Our Business Development Manager is a click away.

Please enable JavaScript in your browser to complete this form.

Get Your Business Quote in 24 Hour

Fill out the form below, and we will be in touch shortly.
Please enable JavaScript in your browser to complete this form.
IPHEX 2025 New Delhi CPHI Frankfurt MESSE FRANKFURT