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Safety Advices
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UNSAFE
Stigmin may cause excessive drowsiness with alcohol.
CONSULT YOUR DOCTOR
Stigmin may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
SAFE IF PRESCRIBED
Stigmin is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
CONSULT YOUR DOCTOR
It is not known whether Stigmin alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react.
CAUTION
Stigmin should be used with caution in patients with kidney disease. Dose adjustment of Stigmin may be needed. Please consult your doctor.
Regular monitoring of kidney function test and some blood tests may advised while you are taking this medicine.
SAFE IF PRESCRIBED
Stigmin is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment of Stigmin may not be needed in these patients. Please consult your doctor.
Medicine Overview of Stigmin 500mcg/ml Injection
Introduction
Stigmin is a prescription medicine used in the treatment of myasthenia gravis (a disease causing muscle weakness and tiredness), paralytic ileus (paralysis of intestinal muscles), post-operative urinary retention and reversal of effect of skeletal muscle relaxants after surgery. Stigmin works by reducing and improving muscle weakness. It may be taken with or without food, preferably at the same time each day. Take this medicine in the dose and duration as advised by your doctor. If you have missed a dose, take it as soon as you remember. Do not skip any doses and finish the full course of treatment. You...
... Show moreUses of Stigmin
- Myasthenia gravis
- Paralytic ileus
- Post-operative urinary retention
- Reversal of effect of skeletal muscle relaxant after surgery
Side effects of Stigmin
Common
- Nausea
- Vomiting
- Abdominal cramp
- Diarrhea
How to use Stigmin
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Stigmin may be taken with or without food, but it is better to take it at a fixed time.
How Stigmin works
Stigmin is a reversible cholinesterase inhibitor. When taken by mouth it increases the level of acetylcholine, a chemical messenger in the brain, by suppressing acetylcholinesterase (enzyme). This acetylcholine further triggers muscle contracting receptors which helps in muscle contraction.
What if you forget to take Stigmin?
If you miss a dose of Stigmin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- Do not drink alcohol while taking this medicine as it may worsen the side effects.
- Inform your doctor if you have an existing kidney problem, parkinson's disease, asthma, or stomach disorders.
Brief Description
Indication
Myasthenia gravis, Paralytic ileus, Post-op urinary retention, Reversal of nondepolarising neuromuscular blockade
Adult Dose
Parenteral
Myasthenia gravis
Adult: 0.5-2.5 mg by IM or SC inj, doses are given at intervals according to response up to a total daily dose of 5-20 mg.
Paralytic ileus and postoperative urinary retention
Adult: 0.5-2.5 mg by SC or IM inj, as required.
Reversal of neuromuscular blockade
Adult: 0.03-0.07 mg/kg by inj over 60 sec, as required.
Not to exceed 0.07 mg/kg or a cumulative total of 5 mg, whichever dose is less Inject by slow IV over at least 1 minute
Child Dose
Parenteral
Myasthenia gravis
Child: <12 yr 0.2-0.5 mg, repeated at suitable intervals throughout the day.
Paralytic ileus and postoperative urinary retention
Child: 0.125-1 mg by SC or IM inj.
Intravenous
Reversal of neuromuscular blockade
Child: 0.05-0.07 mg/kg by inj over 60 sec, as required.
Intramuscular
Neonatal myasthenia gravis
Child: Initially, 0.1 mg, followed by 0.05-0.25 mg or 0.03 mg/kg 2-4 hrly.
Renal Dose
Renal impairment: Dose adjustment may be required.
Contraindication
Mechanical GI or urinary tract obstruction, peritonitis.
Mode of Action
Neostigmine reversibly inhibits acetylcholinesterase and thus potentiates the nicotinic and muscarinic effects of acetylcholine. This facilitates the transmission of impulses across myoneural junction.
Precaution
Patient w/ bronchial asthma, CV disorders (e.g. bradycardia, recent MI, hypotension), peptic ulcer disease, vagotonia, epilepsy, parkinsonism, hyperthyroidism. Patient who underwent recent intestinal or bladder surgery. Renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor ECG, BP and heart rate esp w/ IV use.
Lactation: Unknown if distributed in human breast milk; use caution
Side Effect
Allergic: Allergic reactions and anaphylaxis Neurologic: Dizziness, convulsions, loss of consciousness, drowsiness, headache, dysarthria, miosis and visual changes Cardiovascular: Cardiac arrhythmias (including bradycardia, tachycardia, A-V block and nodal rhythm) and nonspecific EKG changes have been reported, as well as cardiac arrest, syncope and hypotension (predominantly with parenteral dosage form) Respiratory: Increased oral, pharyngeal and bronchial secretions, and dyspnea; respiratory depression, respiratory arrest and bronchospasm have been reported following the use of the injectable form Dermatologic: Rash and urticaria Gastrointestinal: Nausea, emesis, flatulence, and increased peristalsis and salivation Genitourinary: Urinary frequency Musculoskeletal: Muscle cramps and spasms, arthralgia Miscellaneous: Diaphoresis, flushing and...
... Show moreInteraction
May reduce effects of anticholinergics. May increase effects of cholinergic agonists. Increased risk of bradycardia with digoxin, diltiazem, verapamil or beta-blockers without intrinsic sympathomimetic activity. Increased muscle weakness and decreased response to anticholinesterases with corticosteroids. May increase effects of depolarising neuromuscular blockers. Effects may be antagonised by drugs with neuromuscular blocking activity e.g. aminoglycosides, clindamycin, colistin, cyclopropane, halogenated inhalational anaesthetics. Effects may be reduced by quinine, chloroquine, hydroxychloroquine, quinidine, procainamide, propafenone, lithium, beta-blockers. Possible additive toxicity with ophthalmic use of anticholinesterases e.g. ecothiopate.
