Drug interactions
Glycopyrronium + Neostigmine
Severity: Minor
Glycopyrronium and Neostigmine: minor interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Glycopyrronium opposes the muscarinic effects of neostigmine, and the pair is deliberately co-administered at the end of anesthesia to reverse neuromuscular blockade. The antimuscarinic prevents bradycardia, bronchorrhea, salivation and bowel hyperactivity caused by neostigmine. Mismatched dosing or timing can still cause heart rate disturbances.
What this interaction means in plain words
Glycopyrronium and Neostigmine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Glycopyrronium belongs to Respiratory; Neostigmine belongs to Central Nervous System.
Why it happens
Neostigmine inhibits acetylcholinesterase, whereas glycopyrronium competitively blocks muscarinic receptors, so the muscarinic effects are antagonised.
What to do
Give the two together in dose-matched fashion during reversal of neuromuscular block, and monitor heart rate and rhythm.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Glycopyrronium
- Clozapine + Glycopyrronium Major
- Glycopyrronium + Potassium chloride Major
- Abobotulinumtoxina + Glycopyrronium Moderate
- Aclidinium + Glycopyrronium Moderate
- Amantadine + Glycopyrronium Moderate
- Amitriptyline + Glycopyrronium Moderate
Other interactions of Neostigmine
Frequently asked questions
Can I take Glycopyrronium with Neostigmine?
MediHelp rates the interaction as minor. Glycopyrronium and Neostigmine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Glycopyrronium opposes the muscarinic effects of neostigmine, and the pair is deliberately co-administered at the end of anesthesia to reverse neuromuscular blockade. The antimuscarinic prevents bradycardia, bronchorrhea, salivation and bowel hyperactivity caused by neostigmine. Mismatched dosing or timing can still cause heart rate disturbances.
How serious is the interaction between Glycopyrronium and Neostigmine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give the two together in dose-matched fashion during reversal of neuromuscular block, and monitor heart rate and rhythm.
What other medicines interact with Glycopyrronium?
MediHelp also lists interactions of Glycopyrronium with, for example, Clozapine, Potassium chloride, Abobotulinumtoxina. The full list is on the Glycopyrronium page.
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