Neostigmine methylsulfate/glycopyrrolate (By injection)

Glycopyrrolate (glye-koe-PIR-oh-late), Neostigmine Methylsulfate (nee-oh-STIG-meen meth-il-SUL-fate)

Used to reverse effects of non-depolarizing neuromuscular blocking agents (NMBA) after surgery.

Brand Name(s):

Prevduo

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. You should not receive it if you had an allergic reaction to neostigmine methylsulfate or glycopyrrolate, or if you have peritonitis (swelling of the lining of the stomach), stomach or intestinal problems (including achalasia, pyloroduodenal stenosis, paralytic ileus, toxic megacolon, ulcerative colitis), trouble passing urine (including prostatic hypertrophy), glaucoma (eye problem), unstable heart and blood vessel disease, or myasthenia gravis (severe muscle weakness).

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein. This medicine must be given slowly, so the IV tube will need to stay in place for at least 1 minute.
• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how neostigmine methylsulfate/glycopyrrolate works. Tell your doctor if you are using medicine to treat depression (including TCAs), medicine to treat Parkinson's disease, or phenothiazine medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, kidney disease, bradycardia (slow heartbeat), heart failure, heart rhythm problems, hypertension (high blood pressure), or hyperthyroidism (overactive thyroid).
• This medicine may cause the following problems:
  • Eye or vision problems (including glaucoma, increased intraocular pressure)
  • Stomach or bowel problems (including blockage)
  • Tachycardia (fast heartbeat)
• This medicine may make you sweat less, which can cause your body temperature to rise. Be careful when you exercise and during hot weather. You could overheat or get heat stroke.
• This medicine may make you dizzy, drowsy, or cause blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision or other changes in vision, sensitivity of the eyes to light
• Decreased sweating
• Diarrhea
• Fast, slow, or uneven heartbeat

If you notice these less serious side effects, talk with your doctor:

• Dry mouth
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/23/2024