INTRODUCTION

MYOSTIGMIN contain Neostigmine which belongs to a group of medicine called Cholinergic drugs. It is mainly used for the treatment of myasthenia gravis (a chronic autoimmune disorder in which antibodies destruct the communication between nerves and muscle, characterised by weakness in the arm and leg muscles, double vision, trouble speaking and chewing).

MYOSTIGMIN is also used to reverse the effects of muscle relaxants, normalise intestinal movements and treat urinary retention after surgery. MYOSTIGMIN is not recommended for use if you have blockage in your intestine or face difficulty urinating, have peritonitis or any condition where your intestines may no longer be functioning.

Before receiving MYOSTIGMIN tell your doctor if you have asthma, fits, stomach ulcer, Parkinson’s disease or any heart problem. MYOSTIGMIN should be used with caution in pregnant and breast-feeding women.

Your doctor will prescribe the right dose of MYOSTIGMIN for your child depending on their age, body weight and disease condition.The most common side effects of receiving MYOSTIGMIN are slow heartbeat, nausea and vomiting. Contact your doctor if any of the symptoms get worse over time.

USES OF MYOSTIGMIN

Used to:

• Treat myasthenia gravis
• Reverse the effect of muscle relaxants
• Normalise intestinal movements
• Treat urinary retention after surgery

HOW MYOSTIGMIN WORKS

MYOSTIGMIN increases muscle strength by blocking the action of an enzyme in the body which blocks nerve impulses to muscles. By stopping this enzyme from working, it strengthens muscles and thus helps in easing of intestinal movements and urinary retention.

DIRECTIONS FOR USE

MYOSTIGMIN will be given to you only by a doctor or a nurse into a vein as an intravenous infusion. Your doctor will decide the correct dose and duration of treatment for you depending upon your age, body weight and disease condition.

SIDE EFFECTS OF MYOSTIGMIN

HOW TO MANAGE SIDE EFFECTS

Nausea or Vomiting:

Take regular sips of a cold drink. Have ginger or peppermint tea. Stick to simple meals. Avoid eating oily or spicy foods. Get adequate rest. Eat when you feel like it. If symptoms persist, contact your doctor.

Dizziness:

Lie or sit down immediately when you feel dizzy. If you're feeling severe episode of spinning (vertigo), lie in a dark and quite place with eyes closed. Try to avoid vehicle driving. If symptom persists, contact your doctor.

Headache:

Apply hot or cold-water bag on your head. Try to take rest in a quiet and dark room. Drink tea or coffee. Massage on scalp or head with mild pressure. If symptom persists, contact your doctor.

Dry mouth:

Dry mouth can be managed by chewing sugar-free gum or sucking on sugar-free hard candies to stimulate the flow of saliva. Sip water at regular intervals of time. Do not use mouthwashes that contain alcohol because they can be drying. If symptom persists, contact your doctor.

Skin rash:

Avoid hot showers because hot water can irritate the skin. Do not rub or scratch the rash area. Use sunscreen and protective clothing when outdoors. Regularly use moisturizers to soothe and hydrate the affected area. If symptom persists, contact your doctor.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug - Drug interactions:

Before receiving MYOSTIGMIN, inform your doctor if you are taking any of the following medicines:

• certain group of medicines used to treat bacterial infections (Ex. amikacin, gentamycin)
• suxamethonium (used to relax muscle during surgery)

Overdosage:

MYOSTIGMIN will be administered to you only by a doctor or a nurse in a hospital and so it is unlikely to receive an overdose. However, consult your doctor or nurse if you experience any unusual symptoms like nausea, vomiting, diarrhea, sweating, increased bronchial and salivary secretions and slow heartbeat.

SYNOPSIS

MORE INFORMATION

• Keep MYOSTIGMIN out of reach of children
• Store MYOSTIGMIN below 25°C

FAQs ABOUT MYOSTIGMIN

What should I do if I forget to receive a dose of MYOSTIGMIN?

Please stick to the prescribed schedule as agreed with your doctor for optimal efficacy of MYOSTIGMIN treatment. Tell your doctor whenever you forget to receive any dose.

Can MYOSTIGMIN be taken in pregnancy?

Please tell your doctor if you are or think you may be pregnant or are planning to become pregnant before receiving MYOSTIGMIN. Although there are no known untoward effects of this medicine, your doctor will advise the correct course of treatment.

Can MYOSTIGMIN be stopped?

Continue receiving MYOSTIGMIN until your doctor tells you to stop, unless you experience any unwanted effects, worsening of your condition or any new symptoms. Call your doctor in such case.

Can MYOSTIGMIN be used in asthmatic patients?

MYOSTIGMIN should be used with caution in patients having a lung disease called asthma. Consult your doctor for advice. Your doctor will determine a proper dose or select a suitable alternative treatment for you.

Can I take other medicines with MYOSTIGMIN?

Before receiving MYOSTIGMIN, inform your doctor if you are taking, have taken or might take any other medicine, including prescription, over the counter or any herbal medicine, as these might lead to serious side effects by interacting with each other.

REFERENCES

1. KD. Tripathi. Cholinomimetic Alkaloids. Essentials of medical pharmacology. Eighth edition. 2019. Page – 119.

2. Ji W, Zhang X, Liu J, et al. Efficacy and safety of neostigmine for neuromuscular blockade reversal in patients under general anesthesia: a systematic review and meta-analysis. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. November 2021. [Accessed on 2nd July 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667102/

3. Jie Luo , Shuting Chen , Su Min , Lihua Peng.  Reevaluation and update on efficacy and safety.  of neostigmine for reversal of neuromuscular blockade. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. December 2018. [Accessed on 2nd July 2022]. https://pubmed.ncbi.nlm.nih.gov/30573962/

4. Siegfried Hameln GmbH. Electronic Medicines Compendium (EMC) [Revised in November 2021]. [Accessed on 2nd July 2022].    https://www.medicines.org.uk/emc/files/pil.6268.pdf

5. Dr. Reddy’s Laboratories Inc. Neostigmine injection. [Revised in February 2021] [Accessed on 2nd July 2022]. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=81243f47-bd25-bd02-518a-087badcca755&type=display