What the FDA labels say about taking them together
Glycopyrrolate and neostigmine methylsulfate
Neostigmine methylsulfate's FDA label of December 31, 2023 names glycopyrrolate in its warnings and precautions section; the glycopyrrolate labels PlainMeds reads (4) do not name neostigmine methylsulfate. The neostigmine methylsulfate label: “Atropine or glycopyrrolate should be administered prior to BLOXIVERZ to lessen risk of bradycardia.”
Check it at the source: the glycopyrrolate FDA label on DailyMed (effective October 9, 2025, Hikma Pharmaceuticals USA Inc.); the neostigmine methylsulfate FDA label on DailyMed (effective December 31, 2023, Exela Pharma Sciences, LLC).
What does the glycopyrrolate label say about neostigmine methylsulfate?
Glycopyrrolate's label (effective October 9, 2025) and its 3 other brand-application labels do not name neostigmine methylsulfate in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Glycopyrrolate), Hikma Pharmaceuticals USA Inc., effective October 9, 2025 (SPL set 960d2dd0-008d-4ec1-ba2e-9388b28b23e2), via openFDA; the full label on DailyMed
What does the neostigmine methylsulfate label say about glycopyrrolate?
Neostigmine methylsulfate label, warnings and precautionsAtropine or glycopyrrolate should be administered prior to BLOXIVERZ to lessen risk of bradycardia.
Neostigmine Methylsulfate label (Fresenius Kabi USA, LLC, October 15, 2024), warnings and precautionsWARNINGS AND PRECAUTIONS Bradycardia: Atropine or glycopyrrolate should be administered prior to administration of neostigmine methylsulfate injection to lessen risk of bradycardia ( 5.1 ) Coexisting Conditions:
Source: FDA drug label (Neostigmine Methylsulfate, NDA203629), Fresenius Kabi USA, LLC, effective October 15, 2024 (SPL set d0e11e4c-41c3-4874-b567-579db655fba3), via openFDA
Source: FDA drug label (Bloxiverz), Exela Pharma Sciences, LLC, effective December 31, 2023 (SPL set d2f55643-2b0d-4ef9-a9d8-b7138b314372), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Glycopyrrolate | Neostigmine methylsulfate | |
|---|---|---|
| Labeled for | n/a | n/a |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $1.51 per mL 0.2 mg/mL vial | n/a |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once