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    Overview

    Neostigmine bromide is an anticholinesterase agent used in the management of myasthenia gravis and for the reversal of neuromuscular blockade. It works by increasing acetylcholine levels at neuromuscular junctions to improve muscle activity

    Therapeutic class

    Reversible acetylcholinesterase inhibitor (anticholinesterase).

    Chemical name

    (3-Dimethylcarbamoyloxyphenyl)trimethylammonium bromide

    Molecular formula

    C12H19BrN2O2 | Molecular weight: 303.2 g/mol

    Appearance & solubility

    White or almost white crystalline powder, or colourless crystals. Very soluble in water; freely soluble in ethanol (95%). Melting point 175–177 °C

    Clinical applications

    Used to treat myasthenia gravis, to reverse non-depolarising neuromuscular blockade after surgery, and to treat paralytic ileus or urinary retention

    Mode of administration

    Intravenous, intramuscular and subcutaneous routes.

    Pharmacological effects

    A reversible acetylcholinesterase inhibitor that increases acetylcholine concentration at neuromuscular junctions and synapses, promoting muscle contraction and cholinergic transmission. Its main effects include reversing non-depolarising neuromuscular blockade after surgery, improving muscle strength in myasthenia gravis, and increasing gastrointestinal motility

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