Neostigmine

The Basics

What is Neostigmine?

Used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine.

Brand names for Neostigmine

Prostigmin

How Neostigmine is classified

Cholinesterase Inhibitors, Parasympathomimetics

Neostigmine During Pregnancy

Neostigmine pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Neostigmine while pregnant

There are no adequate or well-controlled studies of Prostigmin (neostigmine) in either laboratory animals or in pregnant women. It is not known whether Prostigmin (neostigmine) can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Prostigmin (neostigmine) should be given to a pregnant woman only if clearly needed.

Taking Neostigmine While Breastfeeding

What are recommendations for lactation if you're taking Neostigmine?

Limited data indicate that use of neostigmine to treat myasthenia gravis may be acceptable during breastfeeding, although pyridostigmine may be preferred. Monitor newborns because abdominal cramps after each breastfeeding has been reported. Because of its short half-life, single doses of neostigmine to reverse neuromuscular blockade following surgery are unlikely to adversely affect the breastfed infant more than transiently.

Maternal / infant drug levels

Limited data indicate that use of neostigmine to treat myasthenia gravis may be acceptable during breastfeeding, although pyridostigmine may be preferred. Monitor newborns because abdominal cramps after each breastfeeding has been reported. Because of its short half-life, single doses of neostigmine to reverse neuromuscular blockade following surgery are unlikely to adversely affect the breastfed infant more than transiently.

Possible effects of Neostigmine on milk supply

Relevant published information in nursing mothers was not found as of the revision date. In animals, cholinergic drugs increase oxytocin release,[2] and have variable effects on serum prolactin.[3] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Possible alternatives to Neostigmine

Pyridostigmine.