When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to neostigmine, or if you have an intestine or urinary blockage, or swelling of the lining of your abdomen.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, or into a vein.
• A nurse or other health provider will give you this medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also taking medicine to treat or prevent an infection (such as kanamycin, neomycin, streptomycin), or medicine to treat a heart rhythm problem (such as amiodarone, disopyramide, dofetilide, flecainide, Cordarone®, Norpace®, Tambocor®, Tikosyn®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney or liver disease, myasthenia gravis (severe muscle weakness), asthma, seizures, an overactive thyroid, or stomach problems.
• This medicine may cause your heartbeat to slow. Tell your doctor if you have heart disease, heart rhythm problems, or low blood pressure. You may have a higher risk if you have these heart problems.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fast, slow, or uneven heartbeat
• Lightheadedness or fainting
• Twitching or muscle movements you cannot control, problems with balance or walking

If you notice these less serious side effects, talk with your doctor:

• Drooling, or more saliva than usual
• Nausea, vomiting, diarrhea, stomach pain
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088