Product image of Novistig (Glycopyrronium Bromide, Neostigmine Methylsulfate) supplied by GNH India

Novistig

Active Ingredient:
Glycopyrronium Bromide, Neostigmine Methylsulfate
Origin:
EU

Novistig (Glycopyrronium Bromide, Neostigmine Methylsulfate)

Glycopyrronium bromide and Neostigmine methylsulfate, the active ingredients in Novistig, are anticholinergic and acetylcholinesterase inhibitor agents presented as an injectable solution for intravenous use. They are employed to reverse non‑depolarizing neuromuscular blockade after surgery in adult patients.

GNH India supplies Novistig as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals worldwide.

Manufacturer / TM Owner

Sintetica Gmbh

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Indications & Clinical Uses

Novistig, containing glycopyrronium bromide and neostigmine methylsulfate, is used in the peri‑operative setting to address residual neuromuscular blockade.

  • Reversal of non‑depolarizing neuromuscular blockade: restores normal muscle function after surgery.
  • Post‑operative residual curarization: reduces lingering muscle weakness following anesthesia.
  • Facilitation of spontaneous breathing: enables patients to resume adequate ventilation after neuromuscular blocker use.

How It Works

  • Glycopyrronium bromide competitively blocks muscarinic receptors, reducing parasympathetic secretions, while neostigmine methylsulfate reversibly inhibits acetylcholinesterase, increasing acetylcholine at the neuromuscular junction. The combined effect rapidly counteracts the action of non‑depolarizing neuromuscular blockers, allowing restoration of muscle tone and respiratory function.

Side Effects

Common Side Effects

  • Dry mouth: reduced salivary flow may cause discomfort.
  • Bradycardia: slowing of heart rate can occur during administration.
  • Nausea: patients may feel queasy after dosing.
  • Muscle fasciculations: transient twitching of skeletal muscles.

Serious or Rare Side Effects

  • Bronchospasm: airway constriction requiring immediate attention.
  • Severe hypotension: marked drop in blood pressure that may be life‑threatening.

Precautions & Warnings

Novistig should be administered only under close monitoring of neuromuscular function and cardiovascular status.

  • Assess neuromuscular function before dosing: ensure adequate recovery from blockade.
  • Monitor heart rate and blood pressure: watch for bradycardia or hypotension.
  • Avoid in severe asthma: risk of bronchospasm may be heightened.
  • Use with caution in renal impairment: drug clearance may be reduced.
  • Adjust dose in elderly patients: increased sensitivity to anticholinergic effects.
  • Store at ambient temperature: keep in original container, protect from moisture.

Avoid Interactions

Novistig may interact with several drug classes; awareness of major and moderate interactions helps prevent adverse events.

Major Interactions (Avoid)

  • Other anticholinergic agents: additive anticholinergic burden may cause severe dry mouth or urinary retention.
  • Additional acetylcholinesterase inhibitors: risk of cholinergic excess leading to bradycardia or muscle cramps.
  • Beta‑blockers: may potentiate bradycardic effects.

Moderate Interactions (Monitor Closely)

  • Respiratory depressant anesthetics: combined effect may impair ventilation.
  • Concurrent neuromuscular blocking agents: dose adjustments may be required.
  • Diuretics: electrolyte shifts can influence neuromuscular transmission.

Frequently Asked Questions

Novistig is indicated for the reversal of non‑depolarizing neuromuscular blockade after surgery and for treating postoperative residual curarization. It helps restore normal muscle tone and breathing in patients who have received neuromuscular blocking agents during anesthesia.

Glycopyrronium bromide acts as a competitive antagonist at muscarinic receptors, reducing parasympathetic activity and secretions. This anticholinergic effect complements the acetylcholinesterase inhibition of neostigmine, supporting a balanced reversal of neuromuscular blockade.

The specific dose of Novistig is determined by the prescribing clinician based on the patient’s weight, the type and amount of neuromuscular blocker used, and intra‑operative monitoring. Healthcare professionals calculate the appropriate intravenous amount at the bedside.

Safety data for Novistig in pregnancy and lactation are limited. It should only be used if the potential benefit to the mother outweighs any possible risk to the fetus or infant, and the decision must be made by a qualified healthcare provider.

To request Novistig, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies, and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details (including any cold‑chain requirements), and necessary import documentation.

Novistig combines an anticholinergic (glycopyrronium) with an acetylcholinesterase inhibitor (neostigmine), offering a balanced approach to reversal. Compared with agents that rely solely on acetylcholinesterase inhibition, the addition of glycopyrronium reduces secretions and may lessen bradycardia, providing a distinct safety profile.

Novistig should be stored at ambient temperature, below 25 °C, in its original packaging. Protect the product from moisture and direct sunlight. Do not freeze or expose it to extreme temperatures to maintain stability.

Novistig is given intravenously by a qualified healthcare professional. The solution is injected directly into a vein, typically after confirming the degree of neuromuscular blockade and under continuous cardiac and respiratory monitoring.

Serious risks include bronchospasm and severe hypotension, which can be life‑threatening if not promptly recognized and treated. Continuous monitoring of airway status and blood pressure is essential during and after administration.

Novistig is contraindicated in patients with known hypersensitivity to glycopyrronium, neostigmine, or any excipients, and should be avoided in individuals with severe asthma or uncontrolled cardiac arrhythmias where anticholinergic or cholinergic effects could exacerbate the condition.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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