Physostigmine interactions

Physostigmine, a cholinesterase inhibitor has 78 documented interactions across the FDA labels and fact sheets we index: 29 major, 40 moderate, 9 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (29)

  • AspirinNSAIDMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Aspirin and dipyridamoleantiplatelet agentMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Baclofenmuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • BalsalazidesalicylateMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Bismuth subsalicylatesalicylateMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Carisoprodolmuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Chlorzoxazonemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Cyclobenzaprinemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Dantrolenemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • DiflunisalNSAIDMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • MesalaminesalicylateMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Metaxalonemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Methocarbamolmuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • MethohexitalbarbiturateMajor

    …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Orphenadrinemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • PhenobarbitalbarbiturateMajor

    …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • PrimidoneanticonvulsantMajor

    …spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

  • Pyridostigminecholinesterase inhibitorMajor

    Pyridostigmine bromide extended-release tablets are contraindicated in patients with: Mechanical intestinal or urinary obstruction Known hypersensitivity to pyridostigmine or other anticholinesterase agents Mechanical intestinal or urinary obstruction. (Pyridostigmine label, Contraindications)

  • SalsalateNSAIDMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • SulfasalazinesulfonamideMajor

    Contraindications: ANTICHOLIUM ® should not be used in the presence of hypersensitivity to physostigmine salicylate, bronchial asthma, ulcers associated with tissue destruction (gangrene), coronary heart disease, constipation (mechanical obstipation), mechanical ischuria (urinary retention), hereditary form of muscle atrophy (myotonic dystrophy), closed traumatic… (Physostigmine label, Contraindications)

  • Tizanidinemuscle relaxantMajor

    …obstruction, spasms in the urinary tract collection system, inactivation of nerve and muscle cells after administration of drugs to relax the muscles (depolarization block after depolarizing muscle relaxants), in case of intoxication due to “irreversibly acting” cholinesterase inhibitors (drugs used to treat dementia), intoxication with phosphoric acid esters or barbiturates. (Physostigmine label, Contraindications)

Moderate interactions (40)

  • Amitriptylinetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Amoxapinetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • BupropionantidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • CitalopramSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Clomipraminetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Cocainelocal anestheticModerate

    Cholinesterase inhibitors: Concomitant administration may increase the risk of cocaine toxicity. (Cocaine label, Drug interactions)

  • Desipraminetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • DesvenlafaxineSNRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • DicyclomineanticholinergicModerate

    Dicyclomine hydrochloride should be given to patients with myasthenia gravis only to reduce adverse muscarinic effects of an anticholinesterase (5.4) (Dicyclomine label, Warnings and precautions)

  • Donepezilcholinesterase inhibitorModerate

    In case of simultaneous administration of other cholinesterase inhibitors (e.g. medicines for the treatment of dementia), caution should be exercised because of the potentiating effect. (Physostigmine label, Drug interactions)

  • Doxepintricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • DuloxetineSNRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • EscitalopramSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Esmololbeta blockerModerate

    Anticholinesterases: BREVIBLOC prolonged the duration of succinylcholine-induced neuromuscular blockade and moderately prolonged clinical duration and recovery index of mivacurium. (Esmolol label, Drug interactions)

  • FluoxetineSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • FluvoxamineSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Galantaminecholinesterase inhibitorModerate

    In case of simultaneous administration of other cholinesterase inhibitors (e.g. medicines for the treatment of dementia), caution should be exercised because of the potentiating effect. (Physostigmine label, Drug interactions)

  • Imipraminetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • LevomilnacipranSNRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Memantine and donepezilcholinesterase inhibitorModerate

    In case of simultaneous administration of other cholinesterase inhibitors (e.g. medicines for the treatment of dementia), caution should be exercised because of the potentiating effect. (Physostigmine label, Drug interactions)

  • MirtazapineantidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Naltrexone and bupropionopioid antagonistModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • NefazodoneantidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Neostigminecholinesterase inhibitorModerate

    In case of simultaneous administration of other cholinesterase inhibitors (e.g. medicines for the treatment of dementia), caution should be exercised because of the potentiating effect. (Physostigmine label, Drug interactions)

  • Nortriptylinetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Olanzapine and fluoxetineantipsychoticModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • OxybutyninanticholinergicModerate

    Use with caution due to aggravation of symptoms: Pre-existing dementia in patients treated with cholinesterase inhibitors ( 5.2 ), Parkinson’s disease ( 5.2 ), Myasthenia gravis ( 5.3 ), and Decreased gastrointestinal motility in patients with autonomic neuropathy ( 5.4 ). (Oxybutynin label, Warnings and precautions)

  • ParoxetineSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • PhenelzineMAO inhibitorModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • ProcainamideantiarrhythmicModerate

    Myasthenia Gravis Patients with myasthenia gravis may show worsening of symptoms from PA due to its procaine-like effect on diminishing acetylcholine release at skeletal muscle motor nerve endings, so that PA administration may be hazardous without optimal adjustment of anticholinesterase medications and other precautions. (Procainamide label, Warnings)

  • Protriptylinetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Rivastigminecholinesterase inhibitorModerate

    In case of simultaneous administration of other cholinesterase inhibitors (e.g. medicines for the treatment of dementia), caution should be exercised because of the potentiating effect. (Physostigmine label, Drug interactions)

  • SertralineSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Succinylcholineneuromuscular blockerModerate

    When Phase II block is suspected in cases of prolonged neuromuscular blockade, positive diagnosis should be made by peripheral nerve stimulation, prior to administration of any anticholinesterase drug. (Succinylcholine label, Warnings and precautions)

  • TranylcypromineMAO inhibitorModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • TrazodoneantidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Trimipraminetricyclic antidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • VenlafaxineSNRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • VilazodoneSSRIModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • VortioxetineantidepressantModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

Minor mentions (9)

  • Atracuriumneuromuscular blockerMinor

    ANTICHOLINESTERASE REVERSAL AGENTS SHOULD BE IMMEDIATELY AVAILABLE. (Atracurium label, Warnings)

  • Atropine and pralidoximeanticholinergicMinor

    …ATNAA reactivates cholinesterases and succinylcholine and mivacurium are metabolized by cholinesterases, service members poisoned by susceptible organophosphorus nerve agents having anticholinesterase activity who have received ATNAA may exhibit accelerated reversal of the neuromuscular blocking effects of succinylcholine and mivacurium (relative to poisoned service… (Atropine and pralidoxime label, Drug interactions)

  • CyclopentolateanticholinergicMinor

    Drug Interactions: Cyclopentolate may interfere with the ocular anti-hypertensive action of carbachol, pilocarpine, or ophthalmic cholinesterase inhibitors. (Cyclopentolate label, Drug interactions)

  • DexamethasonecorticosteroidMinor

    Anticholinesterases Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Dexamethasone label, Drug interactions)

  • Dipyridamoleantiplatelet agentMinor

    Cholinesterase Inhibitors Dipyridamole may counteract the anticholinesterase effect of cholinesterase inhibitors, thereby potentially aggravating myasthenia gravis. (Dipyridamole label, Drug interactions)

  • MethylprednisolonecorticosteroidMinor

    Anticholinesterases : Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Methylprednisolone label, Drug interactions)

  • PrednisolonecorticosteroidMinor

    Anticholinesterase agents: Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Prednisolone label, Drug interactions)

  • PrednisonecorticosteroidMinor

    Anticholinesterase Agents Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Prednisone label, Drug interactions)

  • TriamcinolonecorticosteroidMinor

    Anticholinesterases: Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Triamcinolone label, Drug interactions)

Check Physostigmine against everything you take. Add your full list; every pair is checked at once.

Open in the checker

Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.