Neostigmina para la miastenia gravis
Revisado por pares por Sid DajaniÚltima actualización por Michael Stewart, MRPharmSÚltima actualización 2 Jun 2024
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Clinical author's note Michael Stewart 03/06/2024: Neostigmine bromide 15 mg tablets have been discontinued in the UK. Neostigmine injections are available and oral solutions may be available as special orders. Neostigmine tablets may still be available in other countries. This medicine leaflet is based on medical information available in the UK at the time of writing and is left here for reference purposes. Please also refer to the manufacturer's information supplied with your medicine.
Doses vary from person to person so take the tablets exactly as you are directed by your doctor.
The effect of neostigmine tablets lasts for about four hours. Take the tablets at suitable intervals during the day to give you the most strength when needed.
You are likely to be prescribed other medicines to take alongside neostigmine. If you are unsure about how to take any of your medicines, ask your doctor or pharmacist for advice.
De un vistazo
Neostigmine is a medicine used to treat myasthenia gravis, a condition causing muscle weakness.
It works by increasing a chemical called acetylcholine, which helps muscles to contract better.
Take neostigmine tablets exactly as your doctor tells you, usually one or two tablets several times a day.
Common side-effects can include feeling sick, vomiting, diarrhoea, and tummy cramps.
Tell your doctor if you are pregnant, breastfeeding, or have certain health conditions before taking neostigmine.
About neostigmine
Tipo de medicamento | An anticholinesterase |
Usado para | Miastenia gravis |
Disponible como | Tablets (discontinued), injections or special order liquid medicines |
Miastenia gravis is a condition where your muscles become easily tired and weak. There is a fault in the way nerve messages are passed from your nerves to your muscles. As a consequence, your muscles are not stimulated properly, so do not tighten (contract) well. The muscles around the eyes are commonly affected first. Myasthenia gravis is an autoimmune disease. This means that the fault is due to a problem with your immune system. Your immune system (which normally protects your body from infections) mistakenly attacks itself.
Your brain normally sends messages down nerves to the muscles it wants to contract. The nerve endings then release a chemical called acetylcholine. Acetylcholine quickly attaches to small areas on your muscles, called receptors, and this triggers your muscles to contract. In most people with myasthenia gravis, the immune system blocks or damages these acetylcholine receptors. The acetylcholine cannot then attach to the receptor and so the muscle is less able to tighten.
Neostigmine works by slowing the breakdown of acetylcholine when it is released from nerve endings. This means that there is more acetylcholine available to attach to the muscle receptors and this improves the strength of your muscles.
Before taking neostigmine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking neostigmine it is important that your doctor knows:
Si estás embarazada o amamantando.
Si tienes asma.
If you have any of the following conditions: epilepsy, enfermedad de Parkinson, an overactive thyroid gland or baja presión arterial.
If you have a heart condition, such as a slow heart rate, or if you have recently had a ataque al corazón.
If you have a úlcera de estómago.
Si tienes algún problema con el funcionamiento de tus riñones.
If you feel you may have a blockage in your intestines or if you have any difficulties passing urine.
Si está tomando o usando otros medicamentos. Esto incluye cualquier medicamento que esté tomando y que esté disponible para comprar sin receta, así como medicamentos herbales y complementarios.
Si alguna vez has tenido una reacción alérgica a un medicamento.
How to take neostigmine
Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about neostigmine and will provide you with a full list of the side-effects which you may experience from taking it.
Take neostigmine tablets exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said to you. For adults, it is usual to take one or two tablets several times a day, as the effect of the tablets lasts for about four hours. Take the tablets at suitable intervals so that your muscles are strongest when you need to be the most active (for example, early in the morning and before meals). When neostigmine is prescribed for a child, the dose is calculated according to the age of the child.
Swallow the tablet(s) with a drink of water.
If you forget to take a dose at your usual time, take it when you remember. However, if it is nearly time to take your next dose when you remember then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Obteniendo el máximo de tu tratamiento
Intenta mantener tus citas regulares con tu médico. Esto es para que tu médico pueda verificar tu progreso.
It is likely that you will be prescribed other medicines to take alongside neostigmine. You may be prescribed an immunosuppressant or corticosteroid medicine to help control your muscle symptoms. You may also be prescribed tablets to reduce some unwanted effects from taking neostigmine. This is because neostigmine can produce side-effects such as tummy (abdominal) cramp and diarrhoea. If you are unsure when or how to take all these medicines, ask your doctor or pharmacist to explain it to you again.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking neostigmine. This is important because neostigmine interferes with some medicines used during surgery.
Si compras algún medicamento, siempre consulta con un farmacéutico para asegurarte de que sean adecuados para tomar junto con tus otros medicamentos.
Can neostigmine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with neostigmine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common neostigmine side-effects | ¿Qué puedo hacer si experimento esto? |
Sentirse mal (náuseas) o estar enfermo (vómitos), diarrea | Avoid rich or spicy foods, and drink plenty of water. If this becomes troublesome, speak with your doctor who may prescribe you a medicine to help control these symptoms |
Tummy (abdominal) cramps, more saliva produced than usual | If either of these becomes troublesome, speak with your doctor for further advice |
Si experimenta cualquier otro síntoma que crea que puede deberse a las tabletas, hable con su médico o farmacéutico para obtener más consejos.
How to store neostigmine tablets
Mantenga todos los medicamentos fuera del alcance y la vista de los niños.
Almacenar en un lugar fresco y seco, lejos del calor y la luz directos.
Información importante sobre todos los medicamentos
Información importante sobre todos los medicamentos
Nunca tome más de la dosis prescrita. Si sospecha que usted u otra persona podría haber tomado una sobredosis de este medicamento, acuda al departamento de accidentes y emergencias de su hospital local. Lleve el envase con usted, incluso si está vacío.
Este medicamento es para ti. Nunca lo des a otras personas, incluso si su condición parece ser la misma que la tuya.
No guardes medicamentos caducados o no deseados. Llévalos a tu farmacia local, que se encargará de desecharlos por ti.
Si tienes alguna pregunta sobre este medicamento, consulta a tu farmacéutico.
Informar efectos secundarios de un medicamento o vacuna
Si experimenta efectos secundarios, puede reportarlos en línea a través de Sitio web de Yellow Card.

¿Inseguro sobre mezclar medicamentos?
Verifica posibles interacciones entre medicamentos, suplementos y alimentos antes de tomarlos juntos.
Preguntas frecuentes
What is neostigmine used for?
Neostigmine is a medicine used to treat myasthenia gravis, a condition that causes muscle weakness and fatigue. It helps improve muscle strength by increasing the amount of acetylcholine available to stimulate muscles.
What should I do if I forget a dose of neostigmine?
If you miss a dose, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the missed one and continue with your regular dosing. Do not take a double dose to compensate for a missed one.
Are there any specific foods or drinks I should avoid while taking neostigmine?
The article suggests avoiding rich or spicy foods if you experience feeling sick, vomiting, or diarrhoea, as these are listed as common side effects of neostigmine. Drinking plenty of water is also recommended in such cases.
How often do I need to take neostigmine tablets?
For adults, it's common to take one or two tablets several times a day. The effect of the tablets lasts about four hours. You should take them at suitable intervals to ensure your muscles are strongest when you need to be most active, for example, in the morning and before meals.
Is neostigmine suitable for children?
Yes, neostigmine can be prescribed for children. When it is, the dose is specifically calculated based on the child's age.
Can I take other medicines with neostigmine?
It is likely that you will be prescribed other medicines alongside neostigmine, such as immunosuppressants or corticosteroids, to help manage your muscle symptoms. You might also receive tablets to reduce side effects like stomach cramps and diarrhoea. Always check with a pharmacist if you buy any other medicines, including over-the-counter, herbal, or complementary ones, to ensure they are suitable to take with neostigmine.
Lecturas adicionales y referencias
- Manufacturer's PIL, Neostigmine Bromide Tablets 15 mg; Alliance Pharmaceuticals, The electronic Medicines Compendium. Dated January 2015.
- Medicamentos Completos BNF 89ª Edición; Asociación Médica Británica y Sociedad Real de Farmacia de Gran Bretaña, Londres.
Sobre el autorVer biografía completa

Michael Stewart, MRPharmS
Gerente de Revisión de Folletos de Medicamentos – Contratista, Farmacéutico
BPharm (Hons), MRPharmS
Michael es un farmacéutico comunitario que ejerce en Midlands y South Yorkshire con más de 20 años de experiencia asesorando sobre medicamentos y condiciones médicas. Tiene una sólida formación en capacitación en atención médica, habiendo producido e impartido cursos de formación para equipos de farmacia y personal de entornos de atención residencial, incluidas enfermeras. También ha contribuido a juntas asesoras de farmacia para la gestión de condiciones de baja gravedad en la comunidad.
Acerca del revisor

Sid Dajani
Sultan Dajani se graduó en la Escuela de Farmacia de Londres en 1994 y se convirtió en el miembro más joven elegido para el consejo de la Sociedad Real de Farmacia desde su fundación en 1842.
Historial del artículo
La información en esta página está escrita y revisada por pares por clínicos calificados.
Artículo también disponible en Inglés, Alemán, Español, Francés, Italiano, Portugués, Hindi, Hebreo, Árabe, y Sueco.
Próxima revisión: 15 de mayo de 2027
2 Jun 2024 | Última versión

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