Bloxiverz Generic Name & Formulations
Legal Class
Rx
General Description
Neostigmine methylsulfate 0.5mg/mL, 1mg/mL; soln for IV inj; latex-free.
Pharmacological Class
Cholinesterase inhibitor.
How Supplied
Multi-dose vials (10mL)—10
Manufacturer
Generic Availability
YES
Bloxiverz Indications
Indications
To reverse effects of non-depolarizing neuromuscular blocking agents (NMBAs) post-op.
Bloxiverz Dosage and Administration
Adults and Children
See full labeling. Peripheral nerve stimulator and monitoring for twitch responses should be used to determine time of Bloxiverz initiation and the need for additional doses. Individualize. Give by IV inj slowly over a period of at least 1 min. Administer an anticholinergic (eg, atropine sulfate, glycopyrrolate) prior to (if bradycardia present) or concomitantly with Bloxiverz. Reversal of NMBAs with shorter half-lives (eg, rocuronium), or when first twitch response is substantially >10% of baseline or when a second twitch is present: 0.03mg/kg. Reversal of NMBAs with longer half-lives (eg, vecuronium, pancuronium) or when first twitch response is not substantially >10% of baseline or if rapid recovery required: 0.07mg/kg. Max total dose: 0.07mg/kg or up to a total of 5mg, whichever is less.
Bloxiverz Contraindications
Contraindications
Peritonitis. Mechanical obstruction of the intestinal or urinary tract.
Bloxiverz Boxed Warnings
Not Applicable
Bloxiverz Warnings/Precautions
Warnings/Precautions
Should be administered by trained healthcare providers. Have treatment for anaphylaxis readily available. Maintain ventilation and patent airway. Increased risk of BP and HR complications with cardiovascular conditions (eg, coronary artery disease, cardiac arrhythmias, recent acute coronary syndrome) or myasthenia gravis. Neuromuscular dysfunction with large doses; reduce dose if recovery is nearly complete. Differentiate between myasthenic or cholinergic crisis. Renal or hepatic impairment; monitor closely. Elderly (monitor for longer periods). Labor & delivery: may induce premature labor. Pregnancy. Nursing mothers.
Bloxiverz Pharmacokinetics
See Literature
Bloxiverz Interactions
Interactions
Caution with other drugs that may alter activity of metabolizing enzymes or transporters.
Bloxiverz Adverse Reactions
Adverse Reactions
Bradycardia, nausea, vomiting, dry mouth, hypotension, dizziness, headache, insomnia, dyspnea, pruritus; hypersensitivity reactions.
Bloxiverz Clinical Trials
See Literature
Bloxiverz Note
Not Applicable
Bloxiverz Patient Counseling
See Literature
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