What is Physostigmine used for?

Physostigmine is used as an antidote for poisoning from substances like atropine or certain antidepressants, and to treat some issues after surgery.

Can Physostigmine cause heart problems?

Yes, Physostigmine can cause changes in heart rate, such as being too fast or too slow, and may require continuous heart monitoring during use.

Is Physostigmine safe to use if I am pregnant?

The risks for humans are unknown because Physostigmine passes through the placenta, so it should only be used if a doctor deems it absolutely necessary.

What should I do if someone overdoses on Physostigmine?

An overdose can cause seizures and heart issues; medical professionals must use emergency measures like charcoal or gastric lavage and monitor the patient with an ECG.

Will Physostigmine interact with my dementia medication?

Yes, taking other dementia medications alongside Physostigmine can increase its effects, so caution is needed.

What are the most common side effects of Physostigmine?

Common side effects include increased sweating, nausea, vomiting, and excessive saliva.

Can Physostigmine be used for people with asthma?

No, Physostigmine should not be used by people with bronchial asthma.

How is Physostigmine given to patients?

It is given as a slow intravenous (IV) injection or a brief infusion in a saline solution.

Physostigmine | CAS 57-47-6 | PIJVFDBKTWXHHD

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Cholinergic (ophthalmic)

Physostigmine (brand name ANTICHOLIUM) is a medication used primarily as an antidote for certain types of poisoning and to treat specific issues after surgery. It is administered through an IV injection. Because it can affect heart rate and breathing, it is used in controlled medical settings.

How it worksPhysostigmine works by acting as an antidote to block the effects of certain substances that cause anticholinergic poisoning. It helps restore normal functions by interacting with the body's nervous system signals.

Brand names:ANTICHOLIUM

Used for

Antidote for poisoning from alcohol tropane alkaloids (like atropine or scopolamine)Antidote for poisoning from certain antidepressantsAntidote for poisoning from antihistamines or neurolepticsTreating postoperative issues like delayed awakening or shiveringTreating Central anticholinergic syndrome (CAS)

Conditions

Anticholinergic toxicityPostoperative disorders

Class

CholinergicCholinergic (ophthalmic)Nervous systemCardiovascular systemGastrointestinal systemRespiratory system

How to take

FormsIntravenous injection

RoutesIntravenous

In adults, it is given slowly via IV at a dose based on body weight. For intoxication, a starting dose is given followed by additional doses every 20 minutes if needed. For infants, a much lower starting dose is used.

This medication must be administered by a healthcare professional, typically in a hospital setting, as it requires close monitoring of heart activity (ECG).

Key warnings

·Physostigmine can cause life-threatening allergic reactions; emergency medical supplies should be ready.
·When used for certain antidepressant poisonings, there is a risk of cardiac arrest, requiring continuous ECG monitoring.
·The drug may cause serious heart rate changes or breathing problems.

Do not use if

·Allergy to physostigmine salicylate
·Asthma
·Heart disease
·Ulcers with tissue destruction/gangrene
·Constipation or intestinal blockage
·Urinary retention
·Certain muscle diseases like myotonic dystrophy
·Brain injuries
·Poisoning from certain dementia drugs or barbiturates

Side effects

Common

Excessive salivationChanges in heart rate (too fast or too slow)Nausea and vomitingSweatingLow blood pressureBreathing spasms

Serious

·Life-threatening allergic reactions
·Heart rhythm disturbances or cardiac arrest
·Seizures
·Severe low blood pressure

Seek help if

·Allergic reactions
·Difficulty breathing
·Changes in heart rhythm
·Seizures

Interactions

·Other medicines that treat dementia (cholinesterase inhibitors) may increase the effect of Physostigmine.
·Physostigmine should NOT be used if you have taken certain muscle relaxants (succinylcholine/suxamethonium type).

AlcoholPhysostigmine is used as an antidote in cases of intoxication involving certain substances, but it is not a general treatment for alcohol itself.

Special populations

PregnancyThere is no specific data on how Physostigmine affects pregnant women, but the drug does pass through the placenta. It should only be used during pregnancy if a doctor decides it is absolutely necessary.

PediatricIn infants, Physostigmine is used for intoxication at a very low starting dose (0.5 mg) and is carefully monitored to ensure no cholinergic symptoms occur.

Talk to your doctor

Monitor

·Heart rate (tachycardia or bradycardia)
·Mental responsiveness and ability to recognize name/address
·Breathing/respiratory spasms

Questions to ask

·Should I be concerned about my heart rate while taking Physostigmine?
·Are there risks if I have diabetes or Parkinson's disease?
·How will this interact with my current dementia medications?

Practical

OverdoseAn overdose can cause slow heart rate, excessive saliva, vomiting, and seizures. Medical staff will monitor the heart with an ECG and may use treatments like activated charcoal or gastric lavage.

Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-26.