• Anesthetics

Bloxiverz Generic Name & Formulations

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


Generic Availability


Bloxiverz 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


Peritonitis. Mechanical obstruction of the intestinal or urinary tract.

Bloxiverz Boxed Warnings

Not Applicable

Bloxiverz 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


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