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What the FDA labels say about taking them together

Neomycin and neostigmine methylsulfate

Neostigmine methylsulfate's FDA label (Neostigmine Methylsulfate) of October 15, 2024 names neomycin in its drug interactions section; the neomycin label PlainMeds reads does not name neostigmine methylsulfate. The neostigmine methylsulfate label: “Certain antibiotics, particularly neomycin, streptomycin and kanamycin have nondepolarizing neuromuscular blocking action, and therefore, neostigmine dose adjustments may be required to reverse neuromuscular block in …”

Check it at the source: the neomycin FDA label on DailyMed (effective February 12, 2026); the neostigmine methylsulfate FDA label on DailyMed (effective December 31, 2023, Exela Pharma Sciences, LLC).

What does the neomycin label say about neostigmine methylsulfate?

Neomycin's label (effective February 12, 2026) does 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 (Neomycin Sulfate), Aldermed Inc., effective February 12, 2026 (SPL set 4978bb06-8b7c-9a44-e063-6294a90ac4cf), via openFDA; the full label on DailyMed

What does the neostigmine methylsulfate label say about neomycin?

Neostigmine Methylsulfate label (Fresenius Kabi USA, LLC, October 15, 2024), drug interactions

Certain antibiotics, particularly neomycin, streptomycin and kanamycin have nondepolarizing neuromuscular blocking action, and therefore, neostigmine dose adjustments may be required to reverse neuromuscular block in patients who have been taking these drugs.

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

4Neomycin generic labelers
21Neostigmine methylsulfate generic labelers
NeomycinNeostigmine methylsulfate
Labeled forn/an/a
Boxed warningYesNo
Pharmacy cost (NADAC)$0.833 per tablet 500 mg tabletn/a
Shortage nowNo current entryA 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?