Bloxiverz Side Effects Center

Last updated on RxList: 5/23/2022
Bloxiverz Side Effects Center

What Is Bloxiverz?

Bloxiverz (neostigmine methylsulfate) injection is a cholinesterase inhibitor used after surgery to reverse the effects of non-depolarizing neuromuscular blocking agents.

What Are Side Effects of Bloxiverz?

Common side effects of Bloxiverz include:

Dosage for Bloxiverz

Dosage of Bloxiverz is based on the patient's weight. The drug is administered intravenously and is injected slowly over a period of at least 1 minute.

What Drugs, Substances, or Supplements Interact with Bloxiverz?

Bloxiverz may interact with other drugs that may alter the activity of metabolizing enzymes or transporters. Tell your doctor all medications and supplements you use. During pregnancy, Bloxiverz should be used only if needed. It is unknown if this drug passes in breast milk. Consult your doctor before breastfeeding.

Bloxiverz During Pregnancy and Breastfeeding

Additional Information

Our Bloxiverz (neostigmine methylsulfate) Injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


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Bloxiverz Consumer Information

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have muscle weakness as you wake up from surgery.

Common side effects may include:

  • nausea, vomiting; or
  • slow heartbeats.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Bloxiverz (Neostigmine Methylsulfate Injection)


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Bloxiverz Professional Information


Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adverse reactions to neostigmine methylsulfate are most often attributable to exaggerated pharmacological effects, in particular, at muscarinic receptor sites. The use of an anticholinergic agent, e.g., atropine sulfate or glycopyrrolate, may prevent or mitigate these reactions.

Quantitative adverse event data are available from trials of neostigmine methylsulfate in which 200 adult patients were exposed to the product. The following table lists the adverse reactions that occurred with an overall frequency of 1% or greater.

System Organ Class Adverse Reaction
Cardiovascular Disorders bradycardia, hypotension, tachycardia/heart rate increase
Gastrointestinal Disorders dry mouth, nausea, post-procedural nausea, vomiting
General Disorders and Administration Site Conditions incision site complication, pharyngolaryngeal pain, procedural complication, procedural pain
Nervous System Disorders dizziness, headache, postoperative shivering, prolonged neuromuscular blockade
Psychiatric Disorders insomnia
Respiratory, Thoracic and Mediastinal Disorders dyspnea, oxygen desaturation <90%
Skin and Subcutaneous Tissue Disorders pruritus

Post Marketing Experience

The following adverse reactions have been identified during parenteral use of neostigmine methylsulfate. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

System Organ Class Adverse Reaction
Allergic Disorders allergic reactions, anaphylaxis
Nervous System Disorders convulsions, drowsiness, dysarthria, fasciculation, loss of consciousness, miosis, visual changes
Cardiovascular Disorders cardiac arrest, cardiac arrhythmias (A-V block, nodal rhythm), hypotension, nonspecific EKG changes, syncope
Respiratory, Thoracic and Mediastinal Disorders bronchospasm; increased oral, pharyngeal and bronchial secretions; respiratory arrest; respiratory depression
Skin and Sub-cutaneous Tissue Disorders rash, urticaria
Gastrointestinal Disorders bowel cramps, diarrhea, flatulence, increased peristalsis
Renal and Urinary Disorders urinary frequency
Musculoskeletal and Connective Tissue Disorders arthralgia, muscle cramps, spasms, weakness
Miscellaneous diaphoresis, flushing


The pharmacokinetic interaction between neostigmine methylsulfate and other drugs has not been studied. Neostigmine methylsulfate is metabolized by microsomal enzymes in the liver. Use with caution when using BLOXIVERZ with other drugs which may alter the activity of metabolizing enzymes or transporters.

Read the entire FDA prescribing information for Bloxiverz (Neostigmine Methylsulfate Injection)

© Bloxiverz Patient Information is supplied by Cerner Multum, Inc. and Bloxiverz Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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