Drug interactions
Neostigmine + Umeclidinium bromide
Severity: Minor
Neostigmine and Umeclidinium bromide: 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
Umeclidinium is an inhaled long-acting muscarinic antagonist and neostigmine enhances cholinergic activity, so their effects are pharmacologically opposed. Systemic exposure to inhaled umeclidinium is low, so the clinical effect is usually small, although it could slightly blunt the response to neostigmine or the bronchoconstrictive effect of neostigmine may be partly offset.
What this interaction means in plain words
Neostigmine and Umeclidinium bromide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Pharmacodynamic opposition between a cholinesterase inhibitor and a muscarinic receptor antagonist.
What to do
No routine change is needed. Monitor respiratory status and the response to neostigmine in patients with airway disease.
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 Neostigmine
Frequently asked questions
Can I take Neostigmine with Umeclidinium bromide?
MediHelp rates the interaction as minor. Neostigmine and Umeclidinium bromide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Umeclidinium is an inhaled long-acting muscarinic antagonist and neostigmine enhances cholinergic activity, so their effects are pharmacologically opposed. Systemic exposure to inhaled umeclidinium is low, so the clinical effect is usually small, although it could slightly blunt the response to neostigmine or the bronchoconstrictive effect of neostigmine may be partly offset.
How serious is the interaction between Neostigmine and Umeclidinium bromide?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine change is needed. Monitor respiratory status and the response to neostigmine in patients with airway disease.
What other medicines interact with Neostigmine?
MediHelp also lists interactions of Neostigmine with, for example, Huperzine a, Physostigmine, Pyridostigmine. The full list is on the Neostigmine page.
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