Reviewed by Dr Carl Kuschel, Robyn Wilkinson, Brenda Hughes, and Leanne Bratton
October 2001
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Neostigmine Administration




Oral, IM, SC

  1. Administer at least 30 minutes before feeds.

Observation and Documentation

  1. Monitor for signs of adverse effects and cholinergic crisis.
  2. Ensure atropine is available (reverses effects of neostigmine).
  3. Nurse on cardiorespiratory monitor and assess respiratory function closely.
  4. Ensure resuscitation equipment is available.


Selected References

1 Fisher DM, Cronnelly R, Miller RD, Sharma M. The neuromuscular pharmacology of neostigmine in infants and children. Anaesthesiology 1983; 59:220.
2 Goudsouzian NG, Crone RK, Todres ID. Recovery from pancuronium blockade in the neonatal intensive care unit. Br J Anaesth 1981; 53:1303.
3 Parfitt K (Editor) Martindale: The Extra Pharmacopoeia. (32nd ed). Royal Pharmaceutical Society; 1999: London
4 Northern Neonatal Network. Neonatal Formulary 3. London: BMJ Books,2000
5 Neostigmine Data Sheet. Auckland: Astra Zeneca, 1999
6 Paediatric Formulary. (5th ed.) Guy’s, St. Thomas’ and Lewisham Hospitals.
7 Paediatric Pharmacopoeia (12th ed.)Royal Childrens Hospital, Melbourne