Intestinal motility may be slowed, increasing neostigmine absorption. Use with caution. Adjust the neostigmine dose as needed.
Beta-blockers (eg, propranolol)
Severe or prolonged bradycardia may occur because of additive pharmacologic effects. Use with caution. Larger dosages of atropine and sympathomimetic pressor agents may be needed to reverse bradycardia and hypotension.
Use with caution in myasthenic patients; may interfere with neuromuscular transmission. Increase the neostigmine dose as needed.
Quinine may antagonize the effects of neostigmine. Avoid using quinine in patients receiving neostigmine for myasthenia gravis.
Neuromuscular blockade produced by succinylcholine may be prolonged. Avoid this combination in the presence of a depolarizing (phase 1) type of neuromuscular blockade. Use with caution if a nondepolarizing (phase 2) type of blockade is present. Provide mechanical respiratory support as needed.