How it works

Neostigmine is another example of an Acetylcholinesterase inhibitor, or anticholinesterase. Acetylcholinesterase is the enzyme responsible for breaking down Acetylcholine. In patients with myasthenia, Acetylcholine is unable to bind to its receptor due to blockage by autoantibodies. By reducing levels of the enzyme responsible for breaking it down, Neostigmine increases the amount of free Acetylcholine in the body and therefore increases the rate of successful interaction. The difference between Neostigmine and Pyridostigmine is that Pyridostigmine has a slower onset of action and longer duration of action when compared to Neostigmine. Some patients may benefit from this, others may prefer a quicker release of the drug.

How it is delivered

Neostigmine can be delivered orally, or by subcutaneous (to the fat under the skin) or intramuscular (deep into the muscle) injection.

When you have it

The dose is delivered daily, either orally or by injection, depending on prescription.

Side effects

Common: Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, drowsiness, headache, nausea, sore throat, trouble sleeping, vomiting. If any of these symptoms persist, contact your doctor.

Adverse: Blurred or loss of vision, chest pain, discomfort, or tightness, confusion, difficult or laboured breathing, dizziness, faintness, or light-headedness when getting up from a lying or sitting position suddenly, fast, slow, pounding, or irregular heartbeat or pulse, sweating, unusual tiredness or weakness. If any of these symptoms occur, contact your doctor immediately.

Known UK suppliers

AAH Pharmaceuticals Ltd, Advanz Pharma, Martindale Pharmaceuticals Ltd

Report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Click here to report a side effect to the MHRA. 

Treatments