Bloxiverz

Generic name: neostigmine
Drug classes: Cholinergic muscle stimulants, Miscellaneous genitourinary tract agents

Medically reviewed by  A Ras MD.

What is Bloxiverz?

Bloxiverz is a prescription medicine that is used to treat myasthenia gravis. It is used to get back function in muscles after surgery. Bloxiverz may be given to you for other reasons.

Description

Neostigmine methylsulfate, a cholinesterase inhibitor, is (m-hydroxyphenyl) trimethylammonium methylsulfate dimethylcarbamate. The structural formula is:

Neostigmine methylsulfate is a white crystalline powder and is very soluble in water and soluble in alcohol. BLOXIVERZ is a sterile, nonpyrogenic solution intended for intravenous use.

Each mL of the 0.5 mg/mL strength contains neostigmine methylsulfate 0.5 mg, phenol 4.5 mg (used as preservative) and sodium acetate trihydrate 0.2 mg, in water for injection. The pH is adjusted, when necessary, with acetic acid/sodium hydroxide to achieve a value of 5.5.

Each mL of the 1 mg/mL strength contains neostigmine methylsulfate 1 mg, phenol 4.5 mg (used as preservative), and sodium acetate trihydrate 0.2 mg, in water for injection. The pH is adjusted, when necessary, with acetic acid/sodium hydroxide to achieve a value of 5.5.

Mechanism of Action

Neostigmine methylsulfate is a competitive cholinesterase inhibitor. By reducing the breakdown of acetylcholine, neostigmine methylsulfate induces an increase in acetylcholine in the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular blocking agents, and reverses the neuromuscular blockade.

Before taking Bloxiverz, tell your doctor:

• If you are allergic to Bloxiverz; any part of this medicine; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Bowel block, peritonitis, or trouble passing urine.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Bloxiverz with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Bloxiverz?

• Tell all of your health care providers that you take Bloxiverz. This includes your doctors, nurses, pharmacists, and dentists.
• If you are 65 or older, use Bloxiverz with care. You could have more side effects.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

How is Bloxiverz best taken?

Use Bloxiverz as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• It is given as a shot.

What do I do if I miss a dose?

• Call your doctor to find out what to do.

What are the side effects of Bloxiverz that I need to call my doctor about immediately?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Muscle weakness.
• Twitching.
• Swelling in the arms or legs.
• Fever.
• Flushing.
• Shivering.
• Fast, slow, or abnormal heartbeat.
• Shortness of breath.
• Very bad dizziness or passing out.

What are some other side effects of Bloxiverz?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness or headache.
• Upset stomach or throwing up.
• Dry mouth.
• Trouble sleeping.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If overdose is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Bloxiverz?

• If you need to store Bloxiverz at home, talk with your doctor, nurse, or pharmacist about how to store it.

Label

PRINCIPAL DISPLAY PANEL – NDC 76014-002-33 – 0.5 MG VIAL LABEL

PRINCIPAL DISPLAY PANEL – NDC 76014-002-33 – 0.5 MG CARTON LABEL