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Prostigmin (neostigmine) is indicated for the symptomatic treatment of myasthenia gravis. Its greatest usefulness is in prolonged therapy where no difficulty in swallowing is present. In acute myasthenic crisis where difficulty in breathing and swallowing is present, the parenteral form (neostigmine methylsulfate) should be used. The patient can be transferred to the oral form as soon as it can be tolerated.
DOSAGE AND ADMINISTRATION
The onset of action of Prostigmin (neostigmine) given orally is slower than when given parenterally, but the duration of action is longer and the intensity of action more uniform. Dosage requirements for optimal results vary from 15 mg to 375 mg per day. In some instances it may be necessary to exceed these dosages, but the possibility of cholinergic crisis must be recognized. The average dose is 10 tablets (150 mg) administered over a 24-hour period. The interval between doses is of paramount importance. The dosage schedule should be adjusted for each patient and changed as the need arises. Frequently, therapy is required day and night. Larger portions of the total daily dose may be given at times when the patient is more prone to fatigue (afternoon, mealtimes, etc.). The patient should be encouraged to keep a daily record of his or her condition to assist the physician in determining an optimal therapeutic regimen.
Scored, white tablets containing 15 mg neostigmine bromide — bottles of 100 (NDC 0187-3100-10). Imprint on tablets: (front) PROSTIGMIN (neostigmine) 15; (back) ICN.
Valeant Pharmaceuticals North America, One Enterprise. Aliso Viejo, CA 92656 USA. Rev. 08/06.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 3/26/2009
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