Last update Aug. 27, 2022

Neostigmine Bromide


Safe substance and/or breastfeeding is the best option.

Reversible cholinesterase inhibitor used for treatment of Myasthenia gravis and as an analgesic adjuvant in epidural anesthesia, to reverse neuromuscular blockade produced by competitive neuromuscular blockers anad in the treatment of paralytic ileus and glaucoma.. Oral administration, eye drops, intramuscular, intravenous or subcutaneous.

It is not excreted into breastmilk. (Wilson 1981, Fraser 1963 y 1953)

No problems have been observed in infants of mothers treated with neostigmine (Giwa 1981, Fraser 1963). A breastfed neonate whose mother were treated with neostigmine suffered of abdominal colicky pain after a feeding, but the neostigmine plasma levels were undetectable. (Fraser 1963 & 1953)

Because of a low oral bioavailability it seems even more unlikely the pass to the infant’s plasma through ingested breastmilk, except in preterm infants and immediate neonatal period, when there may be an increased intestinal permeability.

On long-term treatments, because there is less published experience than with other drugs of the same group, a known safer alternative would be preferred during the neonatal period and/or in case of prematurity.

Experts authors consider the use of this medication to be probably compatible during breastfeeding. (Briggs 2015, Schaefer 2015, Lee 1993)

See below the information of this related product:


Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Neostigmine Bromide is also known as

Neostigmine Bromide in other languages or writings:


Neostigmine Bromide belongs to this group or family:


Main tradenames from several countries containing Neostigmine Bromide in its composition:


Variable Value Unit
Oral Bioavail. 1 - 2 %
Molecular weight 303 daltons
Protein Binding 15 - 25 %
Tmax 2 hours
0.25 - 1 hours
M/P ratio 0 -


  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  2. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  3. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  4. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  5. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  6. Wilson JT, ed. Drugs in Breast Milk. Balgowlah, Australia: ADIS Press, 1981:17.
  7. Giwa-Osagie OF, Newton JR, Larcher V. Obstetric performance of patients with myasthenia gravis. Int J Gynaecol Obstet. 1981 Abstract
  8. Fraser D, Turner JW. Myasthenia Gravis and Pregnancy. Proc R Soc Med. 1963 Abstract Full text (link to original source)
  9. FRASER D, TURNER JW. Myasthenia gravis and pregnancy. Lancet. 1953 Abstract

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