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Neostigmine Methylsulfate

Neostigmine methylsulfate Prescription
Generic Name: Neostigmine Tablets (nee oh STIG meen)
Brand Name: Prostigmin
Easy-to-read patient leaflet for Neostigmine Tablets. Includes indications, proper use, special instructions, precautions, and possible side effects.
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Neostigmine Methylsulfate Drug Information:

This is not a list of all drugs or health problems that interact with this medicine (neostigmine tablets). Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine (neostigmine tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. Use this medicine (neostigmine tablets) as ordered by your doctor. Read all information given to you. Follow all instructions closely. Learn more

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Neostigmine Methylsulfate Side Effects

For the Consumer

Applies to neostigmine: injection solution

Side effects requiring immediate medical attention

Along with its needed effects, neostigmine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking neostigmine:

More common

  • Blurred or loss of vision
  • chest pain, discomfort, or tightness
  • confusion
  • difficult or labored breathing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • fast, slow, pounding, or irregular heartbeat or pulse
  • lightheadedness, dizziness, or fainting
  • sweating
  • twitches of the muscle visible under the skin
  • unusual tiredness or weakness

Incidence not known

  • Changes in patterns and rhythms of speech
  • cough
  • difficulty in moving
  • difficulty swallowing
  • disturbed color perception
  • double vision
  • halos around lights
  • hives
  • irregular, fast or slow, or shallow breathing
  • itching
  • loss of consciousness
  • muscle cramps and spasms
  • muscle pain or stiffness
  • night blindness
  • no blood pressure or pulse
  • noisy breathing
  • overbright appearance of lights
  • pain in the joints
  • pale or blue lips, fingernails, or skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • skin rash
  • slurred speech
  • stopping of the heart
  • trouble in speaking
  • tunnel vision
  • unconsciousness

Get emergency help immediately if any of the following symptoms of overdose occur while taking neostigmine:

Symptoms of Overdose

  • Constipation
  • decreased sexual ability
  • difficult urination
  • dry mouth
  • enlarged pupils
  • muscle weakness
Side effects not requiring immediate medical attention

Some side effects of neostigmine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at site
  • drowsiness
  • headache
  • increased watering of the mouth
  • nausea
  • sleeplessness
  • sore throat
  • trouble sleeping
  • unable to sleep
  • vomiting

Incidence not known

  • Bloated
  • constricted, pinpoint, or small pupils (black part of eye)
  • diarrhea
  • dry mouth
  • excess air or gas in the stomach or intestines
  • feeling of warmth
  • full feeling
  • increase in mucous from the lungs
  • increased need to urinate
  • increased sweating
  • passing gas
  • passing urine more often
  • redness of the face, neck, arms and occasionally, upper chest
  • redness of the skin
  • skin rash
  • stomach cramps

For Healthcare Professionals

Applies to neostigmine: compounding powder, injectable solution, intravenous solution, oral tablet


Frequency not reported: Bradycardia, tachycardia, decreased cardiac conduction (in severe cases possibly leading to heart block or cardiac arrest), hypotension, syncope


Frequency not reported: Hyperhidrosis, rash, urticaria, pruritus


Frequency not reported: Nausea, vomiting, diarrhea, abdominal cramps, flatulence, dry mouth, salivary hypersecretion, increased intestinal motility (which may result in involuntary defecation)


Frequency not reported: Urinary incontinence


Frequency not reported: Hypersensitivity, angioedema, anaphylactic reaction


Frequency not reported: Muscle spasm, muscle cramps, fasciculation

Nervous system

Frequency not reported: Cholinergic syndrome (especially at high doses; in patients with myasthenia gravis, cholinergic crisis may be difficult to distinguish from myasthenia crisis), headache, dizziness, convulsions, loss of consciousness, coma, drowsiness, restlessness, ataxia, slurred speech, general weakness, paralysis


Frequency not reported: Miosis, lacrimation increased, vision changes, nystagmus


Frequency not reported: Increased bronchial secretion, bronchospasm, dyspnea, respiratory depression, respiratory arrest, tight chest, wheezing


Frequency not reported: Agitation, fear, insomnia

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.

Source: Drugs.com Neostigmine Methylsulfate (www.drugs.com/cdi/neostigmine-tablets.html).