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Name of the generic: physostigmine [ FYE-so-STIG-meen
Brand name: Antilirium.
Dosage form: injectable solution (1 mg/mL)
Drug class: antidote

What is Physostigmine?

Physostigmine alters the chemical balance within the body that regulates the messages sent by nerve cells to muscles that trigger movement. The drug Physostigmine helps counter the effects of some drugs or substances that hinder communication between nerves and muscles. These include atropine belladonna, scopolamine, and antihistamines, as well as some antidepressants and other anticholinergic (AN TYE KOE Lin ER Jik) substances. The physostigmine drug can also be utilized for reasons not mentioned in this guideline.

Side effects of Physostigmine

Contact a medical professional immediately. Get medical attention immediately if you notice symptoms or warning signs of an allergic response, such as symptoms of hives, difficulty breathing, or swelling of your lips, face, and tongue.

Inform your caregivers immediately. If you suffer from:

  • More frequent urination, or increased more frequent bowel movement;
  • Stomach cramps;
  • More severe or even worsening nausea that is severe or worsening nausea that is severe or worsening the vomiting;
  • More transpiration;
  • Blurred vision or
  • The mouth is brimming with saliva.

Common side effects of physostigmine can include:

  • Nausea, vomiting;
  • An increase in salivation more salivation
  • Slow heartbeats.

This is not a comprehensive list of possible side effects, and others could happen. Consult your physician to seek medical advice on the effects. You can report any side effects to the FDA at 1-800-FDA-1088.


In an emergency, it might be difficult to inform your medical professionals about your medical conditions. It is important that the doctor who cares for you following the incident knows that you've been treated with physostigmine.

Prior to use this drug

It is not recommended to treat with physostigmine in the event that you are sensitive to the substance or are suffering from

  • asthma;
  • diabetes;
  • bladder obstruction or other issues;
  • A blockage within your digestive tract (stomach or the intestines);
  • coronary disease or
  • Gangrene (damaged muscles and skin due to an infection or a lack of blood circulation)

If you can, before receiving physostigmine, inform your doctor when:

  • You have a sulfite reaction.
  • You have taken You have recently taken Ultracet (acetaminophen along with tramadol). You may also have
  • You frequently use bupropion on a regular basis (Wellbutrin, Zyban, Aplenzin, Forfivo, and many others).

In an emergency, it may not be feasible to inform your family members that you're nursing or pregnant. Make sure any medical professional who is caring for you or your baby knows that you've received this medication.

How to take Physostigmine?

The physostigmine injection is made into a muscle or a vein via an IV. Your healthcare provider will offer the injection. In the event of an injection into the vein, physostigmine should be administered slowly. Your blood pressure, breathing levels, oxygen levels, and many other vital indicators will be closely monitored during the time you are taking physostigmine. It is possible that you will require a second dose of physostigmine based on the response of your body to it. Your physician will decide how long you will be treated with physostigmine.

Details on dosage

Usual Adult Dose for Anticholinergic Syndrome:

Post-anesthesia care:

The first dose is 0.5–1 mg, either IM or slow IV, but not more than 1 mg/min.
You may repeat the dose in 10- to 30-minute intervals if the desired response is not observed.

Drugs that overdose can cause the condition known as anticholinergic:

2 mg, intramuscular, or a slow IV at not more than 1 mg/minute
Dosage may be repeated if life-risky symptoms (e.g., arrhythmia, convulsions, or coma) occur.

Usual Pediatric Dose for Anticholinergic Syndrome:

0.02 mg/kg IM or IV slowly less than 0.5 mg/min
Repeat doses in 5- to 10-minute intervals if the toxic effects persist (and there are no cholinergic reactions) until a therapeutic result is achieved.
Maximum dose: 2 mg

What happens if I miss the dose?

Since you'll be receiving physostigmine in a clinical setting, you're not likely to miss the dose.

What happens if I overdose?

Since physostigmine is administered by a health expert in a medical environment, it is extremely unlikely for an overdose to occur.

What should be avoided?

Follow your doctor's recommendations regarding any beverages, food, or other activities.

Interaction with other drugs

Other medications may interfere with physostigmine. This includes prescription and non-prescription medicines, vitamins, and herbal products. Be sure to inform your health professionals about any medications you take in the present and about any medication that you decide to stop or change your use of.