Neostigmine dosing
Reversal · 1 mg/mL · IV Push
Calculated, not generatedWeight-based dose
| Dose | Per kg | For 70 kg |
|---|---|---|
| low | 0.03 mg/kg | 2.1 mg |
| standard | 0.05 mg/kg | 3.5 mg |
| high | 0.07 mg/kg | 4.9 mg |
Max 5 mg. Give with glycopyrrolate.
Renal & hepatic adjustment
- Severe (eGFR <30 / dialysis)Renal elimination is prolonged in renal failure (parallels the prolonged block) — titrate to TOF and confirm adequate reversal.
Source: Miller's Anesthesia
Onset, duration & pearls
Onset5-15 min
Duration40-60 min
Side effects: Bradycardia, Bronchospasm, PONV, Increased secretions.
- Requires TOF count ≥2 twitches
- Always co-administer glycopyrrolate
Evidence A · Decades of evidence for NMB reversal
More reversal
Get the exact dose for your patient
Vigil computes Neostigmine for your patient's actual weight — and adjusts for renal or hepatic impairment automatically, with the cited rationale. The number is calculated from a verified database, never guessed.
Decision support for licensed clinicians — not a substitute for clinical judgment. Always verify against the package insert and the patient in front of you.