glycopyrronium + neostigmine

A combination of neostigmine, an acetylcholinesterase inhibitor, and glycopyrronium (also known as glycopyrrolate), a muscarinic antagonist. This combination is primarily indicated for the reversal of residual neuromuscular blockade induced by non-depolarizing neuromuscular blocking agents (NMBAs) following surgery under general anesthesia. Neostigmine works by inhibiting the enzyme acetylcholinesterase, thereby increasing the concentration of acetylcholine at the neuromuscular junction to compete with and displace NMBAs. Glycopyrronium is co-administered to mitigate the systemic muscarinic effects of neostigmine, such as bradycardia, bronchoconstriction, and excessive salivation. Clinical trials, such as those conducted by The Third Xiangya Hospital of Central South University, evaluate this combination against the traditional neostigmine-atropine pairing to assess its impact on perioperative heart rate stability.

Brand names

Robinul-Neostigmine

Other names

glycopyrrolate + neostigmineneostigmine methylsulfate + glycopyrronium bromideneostigmine + glycopyrronium