Product Monograph - Neostigmine Methylsulfate Injection USP (Marcan Pharmaceuticals)
SYMPTOMS AND TREATMENT OF OVERDOSAGE
Symptoms: Muscarinic and nicotinic effects (see ADVERSE REACTIONS). Distinguish from myasthenic crisis with edrophonium chloride, if necessary.
Treatment: Control muscarinic effects with IV atropine, followed by intramuscular (IM)
atropine every 2 to 4 hours. Assist ventilation and treat convulsions or shock if necessary.
For management of a suspected drug overdose, contact your regional Poison Control
Centre immediately.
DOSAGE AND ADMINISTRATION
Intestinal atony, postoperative: Prophylaxis: 250 mcg subcutaneous (SC) or IM before or immediately after operation, repeated every 4 to 6 hours SC. Treatment: 500 mcg SC, IM (or possibly IV) repeated at intervals of 4 to 5 hours.
Urinary Retention: Prophylaxis: 250 mcg as for intestinal atony. Treatment: 500 mcg SC or IM and apply heat to the lower abdomen. If urination does not occur within one hour, the patient should be catheterized. After the patient has voided, continue the 500 mcg injections at
3-hour intervals for at least 5 additional injections.
Curare Antagonist (to neutralize the effect of curare in surgical anesthesia and shock therapy): 0.5 to 2 mg IV. Atropine sulfate 0.6 to 1.2 mg IV should also be given.
DOSAGE FORMS, COMPOSITION, AND PACKAGING
0.5 mg/mL: Each mL contains Neostigmine Methylsulfate 0.5 mg, Phenol 0.45%, Sodium Acetate Trihydrate, Acetic Acid and Sodium Hydroxide as a buffer to adjust the pH and Water for Injection. Available in multidose vial of 10 mL, boxes of 10.
1 mg/mL: Each mL contains Neostigmine Methylsulfate 1 mg, Phenol 0.45%, Sodium Acetate Trihydrate, Acetic Acid and Sodium Hydroxide as a buffer to adjust the pH and Water for Injection. Available in multidose vial of 10 mL, boxes of 10.
STORAGE AND STABILITY
Store between 15 and 3 0 °C. Protect from light. Multiple use. Discard 28 days after initial use.
Do not use product if mixture (solution) shows haziness, particulate matter, discolouration, or leakage.
REFERENCES
- 1) Neostigmine Methylsulfate Injection USP Prescribing Information, Sandoz Canada Inc., Date of revision: November 12, 2007.
- 2) Neostigmine Methylsulfate Injection USP Prescribing Information, Omega Laboratories Limited, Date of revision: May 24, 2012.