When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to neostigmine or bromides, or if you have a blockage in your intestines or urinary tract.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Your doctor may ask you to keep a record of how this medicine effects you. This will help to determine if your dosing schedule needs to be changed.

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 using antibiotics, medicines for heart rhythm problems, or anesthetics.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breast feeding. Tell your doctor if you have asthma, heart rhythm problems, seizures (epilepsy), overactive thyroid, or stomach problems.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

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.
• Seizures.
• Severe muscle weakness with slow, shallow breathing.
• Twitching, or muscle movements you cannot control.

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

• Diarrhea, stomach cramps, gas, nausea, or vomiting.
• Dizziness or weakness.
• Headache.
• Increased saliva, watery eyes, runny nose.
• Increased sweating.
• Joint pain, muscle cramps.
• Mild skin rash or itching.

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