Glycosting (0.5/2.5mg) 1ml, 10 Ampoule Injections

The combination of Neostigmine Metilsulfate and Glycopyrronium Bromide in this injection has a synergistic effect. Neostigmine Metilsulfate, a cholinesterase inhibitor, prevents the breakdown of acetylcholine, leading to increased acetylcholine levels at neuromuscular junctions. This results in enhanced neuromuscular transmission and muscle contraction. Conversely, Glycopyrronium Bromide, an anticholinergic agent, blocks the action of acetylcholine at muscarinic receptors, reducing excessive secretions and preventing the side effects of neostigmine-induced cholinergic stimulation, such as increased salivation, sweating, and gastrointestinal motility.

Anticholinesterase/Anticholinergic.

Injection

The following are the uses of Neostigmine Metilsulfate 2.5mcg, Glycopyrronium Bromide 0.5 injection:

• Used for reversing the effects of non-depolarizing neuromuscular blocking agents after surgery or mechanical ventilation.
• Used to treat postoperative abdominal distension and urinary retention.
• Used to improve muscle strength and respiratory function in myasthenia gravis patients.
• Used to manage symptoms in patients with neurogenic bladder.
• Used to reduce excessive saliva production during anesthesia.
• Used to aid in the diagnosis of certain neuromuscular disorders.
• Used to facilitate tracheal intubation by reducing secretions.

In the case of an overdose of Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection, symptoms may include severe nausea, vomiting, diarrhea, excessive salivation, and sweating. The patient may also experience difficulty breathing, a slow heart rate, and potential cardiac arrest. Prompt medical intervention is necessary, including gastric lavage, administration of activated charcoal, and supportive care to manage symptoms and prevent further complications.

In the case of a missed dose of Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection, it is important to administer the medication as soon as you remember. If it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one. Consult your healthcare professional if you have any concerns or questions regarding missed doses.

To administer the Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection, draw the medication into a syringe and inject it intramuscularly or intravenously as directed by your healthcare professional, ensuring a slow and controlled injection.

Following are the conditions/situations when Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5mg injection should not be used:

• Should not be used in individuals with a known allergy to either Neostigmine Metilsulfate or Glycopyrronium Bromide.
• Contraindicated in patients with gastrointestinal obstruction, as it may worsen the condition.
• Not recommended for patients with mechanical bowel obstruction or perforation.
• Should not be used in individuals with severe urinary tract obstruction.
• Contraindicated in patients with severe asthma or chronic obstructive pulmonary disease (COPD).
• Not suitable for patients with a history of hypersensitivity reactions to anticholinergic medications.
• Should be avoided in individuals with a known or suspected myasthenia gravis crisis.

The side effects of Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection may include:

• Increased heart rate
• Nausea and vomiting
• Excessive sweating
• Abdominal cramps
• Diarrhea
• Muscle weakness
• Blurred vision or eye pain
• Allergic reactions (e.g., skin rash, itching, difficulty breathing)

Following are the precautions and warnings for Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection:

• This medication should be used with caution in patients with known allergies to cholinesterase inhibitors or anticholinergic agents, as it may trigger an allergic reaction.
• Not recommended for patients with mechanical obstruction of the gastrointestinal or urinary tract, as it can exacerbate these conditions.
• Administer with caution in individuals with a history of cardiac disorders, as it may cause bradycardia or cardiac arrest.
• Close monitoring is required for patients with myasthenia gravis, as the medication may exacerbate muscle weakness.
• Should be avoided during pregnancy and breastfeeding unless the potential benefits outweigh the risks.
• May cause blurred vision and dizziness; patients should avoid driving or operating heavy machinery until the effects are known.
• Elderly patients may be more susceptible to the side effects of this medication, and dosage adjustments might be necessary.
• This medication should be used with caution in patients with impaired liver or kidney function, as it is primarily metabolized and excreted by these organs.

Following are the drug interactions for Neostigmine Metilsulfate 2.5mcg, Glycopyrronium Bromide 0.5mcg injection:

• Antimuscarinic drugs, such as atropine or scopolamine, may reduce the effectiveness of neostigmine and can lead to increased cholinergic side effects.
• Neostigmine can potentiate the effects of succinylcholine, a muscle relaxant, prolonging its duration of action.
• The use of beta-blockers may reduce the effectiveness of glycopyrronium bromide, as it may decrease the heart rate response.
• Concomitant use with other anticholinergic medications may increase the risk of adverse effects, such as dry mouth, blurred vision, and urinary retention.
• Drugs that affect neuromuscular transmission, like aminoglycoside antibiotics, can interact with neostigmine and impact respiratory function.
• Certain anti-inflammatory medications, like corticosteroids, may enhance the effects of glycopyrronium bromide and increase the risk of side effects.
• Caution is advised when using neostigmine with medications that affect cholinergic receptors, as it may alter the response to treatment.

Following are the food interactions for Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection:

• Grapefruit and grapefruit juice should be avoided as they may influence the drug's metabolism and potentially lead to increased side effects.
• Alcohol is generally not recommended as it can enhance the sedative effects of the medication, causing increased drowsiness and impaired coordination.
• Avoid caffeine-rich foods and beverages as they may counteract the relaxing effects of Glycopyrronium Bromide, potentially leading to reduced efficacy.
• Foods high in potassium, such as bananas, oranges, and spinach, should be consumed with caution as Neostigmine can affect potassium levels.
• Maintain a balanced diet, as the medication may cause fluctuations in appetite and weight.
• Stay hydrated by drinking plenty of fluids, especially water, to support overall health and medication tolerance.
• Avoid high-fat meals as they might influence the absorption of the medication.
• Consult your healthcare provider for personalized dietary advice based on your medical history and condition.

Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection should be stored in a controlled environment, preferably in a cool and dry place away from direct sunlight and moisture. The injections should be kept in their original packaging, ensuring the container is tightly sealed to maintain sterility. It is crucial to adhere to the recommended storage conditions to preserve the integrity and potency of the medication. When disposing of unused or expired injections, it is advised to follow local guidelines for pharmaceutical waste disposal, avoiding flushing or pouring them down the drain. Instead, consult healthcare professionals or pharmacists for appropriate disposal methods to minimize environmental impact. Keep the injections out of children's reach to prevent accidental exposure or ingestion.

Following are the quick tips for Neostigmine Metilsulfate 2.5mcg and Glycopyrronium Bromide 0.5 injection:

• Ensure the injection is administered by a trained healthcare professional.
• Verify the medication's identity before administration to prevent medication errors.
• Administer the injection as prescribed, typically into a muscle or under the skin.
• Follow the prescribed dosage instructions; do not adjust the dose without medical advice.
• Report any known allergies or adverse reactions to your healthcare provider immediately.
• Store the medication as directed, usually at room temperature, away from light and moisture.
• Dispose of used needles and syringes safely in designated sharps containers.
• In case of any side effects or unusual symptoms, seek medical attention promptly.