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Details

Stereochemistry ACHIRAL
Molecular Formula C12H19N2O2
Molecular Weight 223.2919
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 1

SHOW SMILES / InChI
Structure of NEOSTIGMINE

SMILES

CN(C)C(=O)Oc1cccc(c1)[N+](C)(C)C

InChI

InChIKey=ALWKGYPQUAPLQC-UHFFFAOYSA-N
InChI=1S/C12H19N2O2/c1-13(2)12(15)16-11-8-6-7-10(9-11)14(3,4)5/h6-9H,1-5H3/q+1

HIDE SMILES / InChI

Description
Curator's Comment:: Description was created based on several sources, including https://www.drugs.com/pro/neostigmine-methylsulfate-injection.html

Neostigmine is a cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier. By inhibiting acetylcholinesterase, more acetylcholine is available in the synapse, therefore, more of it can bind to the fewer receptors present in myasthenia gravis and can better trigger muscular contraction. Neostigmine is used for the symptomatic treatment of myasthenia gravis by improving muscle tone.

CNS Activity

Curator's Comment:: Neostigmine, unlike physostigmine, does not cross the blood-brain barrier.

Originator

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
91.0 nM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Prostigmin

Approved Use

Neostigmine is used for: Treating myasthenia gravis.

Launch Date

-9.7839363E11
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
300 ng/mL
0.07 mg/kg single, intravenous
dose: 0.07 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEOSTIGMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
69.9 ng × h/mL
0.07 mg/kg single, intravenous
dose: 0.07 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEOSTIGMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
79.8 min
0.07 mg/kg single, intravenous
dose: 0.07 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEOSTIGMINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
1.5 h
0.03 mg/kg single, intravenous
dose: 0.03 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEOSTIGMINE plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
75%
0.03 mg/kg single, intravenous
dose: 0.03 mg/kg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEOSTIGMINE plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
yes
yes (co-administration study)
Comment: information obtained from abstract: AUC of coadministered drug, parathion, parathion was significantly greater than control (65.1 versus 74.3 microg min/ml)
PubMed

PubMed

TitleDatePubMed
The prevention of muscle pains associated with the use of suxamethonium.
1967 Dec
Myasthenia gravis syndrome associated with trimethadione.
1970 Jun 29
Prolonged curarization in a patient with renal failure. Case report.
1971 May
Recurarization--fact or fiction.
1971 Sep-Oct
Antagonism of succinylcholine paralysis in a patient with atypical pseudocholinesterase.
1972 May
Thioridazine toxicity. Agranulocytosis and hepatitis with encephalopathy.
1973 Apr 23
On the interaction of drugs with the cholinergic nervous system--V. Characterization of some effects induced by physostigmine in mice: in vivo and in vitro studies.
1978 Jan 15
Neuropharmacology of the parasitic trematode, Schistosoma mansoni.
1983 Jan
Effect of halogenated anaesthetics on heart rate changes during reversal of neuromuscular block with glycopyrrolate and neostigmine.
1984 Nov
Abnormal responses to morphine-neostigmine in patients with undefined biliary type pain.
1985 Dec
Refractory bradycardia after reversal of muscle relaxant in a diabetic with vagal neuropathy.
1986 Nov
Prolonged bradycardia and hypotension after neostigmine administration in a patient receiving atenolol.
1987 Dec
Spinal cholinergic neurons and the expression of morphine withdrawal symptoms in the rat.
1987 Mar
Portal hypertension secondary to azathioprine in myasthenia gravis.
1988 Dec
Impairment of the antagonism of vecuronium-induced paralysis and intra-operative disopyramide administration.
1989 Jan
Complete heart block following glycopyrronium/neostigmine mixture.
1989 May
Sensitivity to both vecuronium and neostigmine in a sero-negative myasthenic patient.
1989 Oct
Prolonged paralysis following suxamethonium and the use of neostigmine.
1990 Sep
Propofol bradycardia.
1991 Jan
Acetylcholinesterase fiber-optic biosensor for detection of anticholinesterases.
1991 May
Reversal of antihypertensive agent-induced postural hypotension with physostigmine.
1991 May-Jun
Intrathecal cholinergic agonists lessen bupivacaine spinal-block-induced hypotension in rats.
1994 Jul
Interaction between intrathecal neostigmine and epidural clonidine in human volunteers.
1996 Aug
Spinal neostigmine diminishes, but does not abolish, hypotension from spinal bupivacaine in sheep.
1996 Nov
Subarachnoid neostigmine does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
1996 Nov-Dec
Effect of long-term administration of berberine on scopolamine-induced amnesia in rats.
1997 Jul
Postoperative reparalysis after rocuronium following nebulized epinephrine.
1997 Mar
Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration.
1997 Nov
A multi-center study of intrathecal neostigmine for analgesia following vaginal hysterectomy.
1998 Oct
[Myasthenia in elderly patients: a series of 23 cases].
2005 Dec
Myasthenia gravis accompanied with hypokalemic periodic paralysis.
2006 May
Synthesis and screening for acetylcholinesterase inhibitor activity of some novel 2-butyl-1,3-diaza-spiro[4,4]non-1-en-4-ones: derivatives of irbesartan key intermediate.
2007 Dec 1
Fresh frozen plasma transfusion for reversal of prolonged post-anaesthesia apnoea.
2008 Apr
Heart block and prolonged Q-Tc interval following muscle relaxant reversal: a case report.
2008 Feb
Sphincter of Oddi and its dysfunction.
2008 Jan
Neostigmine and pilocarpine attenuated tumour necrosis factor alpha expression and cardiac hypertrophy in the heart with pressure overload.
2008 Jan
The role of Wnt signaling in neuronal dysfunction in Alzheimer's Disease.
2008 Jul 24
Prucalopride: the evidence for its use in the treatment of chronic constipation.
2008 Jun
The effect of piroxicam on the formation of postoperative, intraabdominal adhesion in rats.
2008 Oct
Interventions for heartburn in pregnancy.
2008 Oct 8
Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing.
2008 Sep
Neostigmine decreases bupivacaine use by patient-controlled epidural analgesia during labor: a randomized controlled study.
2009 Aug
Determining the neurotransmitter concentration profile at active synapses.
2009 Dec
A two cases clinical report of mandragora poisoning in primary care in Crete, Greece: two case report.
2009 Dec 16
Relationship between anti-acetylcholine receptor antibody titres and severity of myasthenia gravis.
2009 May
Dr Lazar Remen (1907-74): a forgotten pioneer in the treatment of myasthenia gravis.
2009 May
Myasthenia gravis and autoimmune Addison disease in a patient with thymoma.
2009 Sep
The validation of an in vitro colonic motility assay as a biomarker for gastrointestinal adverse drug reactions.
2010 Jun 15
A comparative study of two different doses of epidural neostigmine coadministered with lignocaine for post operative analgesia and sedation.
2010 Oct
Efficacy of bupivacaine-neostigmine and bupivacaine-tramadol in caudal block in pediatric inguinal herniorrhaphy.
2010 Sep
Patents

Sample Use Guides

The recommended dose range of Neostigmine Methylsulfate Injection is 0.03 mg/kg to 0.07 mg/kg administered as an intravenous bolus.
Route of Administration: Intravenous
In vitro, neostigmine (10⁻⁵ and 10⁻⁴ M) potentiated neurogenic relaxations in the rabbit corpus cavernosum.
Name Type Language
NEOSTIGMINE
HSDB   MART.   MI   VANDF  
Common Name English
NEOSTIGMINE [VANDF]
Common Name English
NEOSTIGMINE ION
Common Name English
BENZENAMINIUM, 3-(((DIMETHYLAMINO)CARBONYL)OXY)-N,N,N-TRIMETHYL-
Systematic Name English
NEOSTIGMINE [MI]
Common Name English
NEOSTIGMINE CATION
Common Name English
NEOSTIGMINE (CATION)
Common Name English
NEOSTIGMINE [HSDB]
Common Name English
NEOSTIGMINE [MART.]
Common Name English
Classification Tree Code System Code
WHO-ATC N07AA01
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-ESSENTIAL MEDICINES LIST 20
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
FDA ORPHAN DRUG 388812
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-ATC S01EB06
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-VATC QA03AB93
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
LIVERTOX 677
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-ATC N07AA51
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
NDF-RT N0000175723
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-VATC QN07AA51
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
NCI_THESAURUS C47792
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-VATC QN07AA01
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
WHO-VATC QS01EB06
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
Code System Code Type Description
MESH
D009388
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
EPA CompTox
59-99-4
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
PUBCHEM
4456
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
RXCUI
7315
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY RxNorm
EVMPD
SUB03411MIG
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
WIKIPEDIA
NEOSTIGMINE
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
DRUG BANK
DB01400
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
DRUG CENTRAL
1897
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
MERCK INDEX
M7819
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY Merck Index
FDA UNII
3982TWQ96G
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
ChEMBL
CHEMBL278020
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
NCI_THESAURUS
C75024
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
HSDB
3921
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
CAS
59-99-4
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY
LACTMED
Neostigmine
Created by admin on Sat Jun 26 16:22:20 UTC 2021 , Edited by admin on Sat Jun 26 16:22:20 UTC 2021
PRIMARY