n this Leaflet:

1.    What Neostigmine Bromide Tablets are and what they are used for

2.    Before you take Neostigmine Bromide Tablets

3.    How to take Neostigmine Bromide Tablets

4.    Possible side effects

3. How to store Neostigmine Bromide Tablets

3. Further information_

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This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5. HOW TO STORE NEOSTIGMINE BROMIDE TABLETS

Keep out of the reach and sight of children.

The product should not be used after the expiry date printed on the label. Keep at room temperature, below 30°C and away from direct light._

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I he following side effects have been reported:

•    nausea

•    vomiting

•    abdominal cramps

•    increased production of saliva

•    diarrhoea

Reporting of side effects

If you get any side effects, talk to your doctor, nurse or pharmacist.

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1. WHAT NEOSTIGMINE BROMIDE TABLETS ARE AND WHAT THEY ARE USED FOR

Neostigmine Bromide Tablets block the action of an enzyme in the body which "switches off" nerve impulses to muscles. By stopping this enzyme from working, Neostigmine Bromide can increase muscle strength, but only in certain conditions.

Neostigmine Bromide Tablets are mainly used for the treatment of myasthenia gravis, a disease in which the muscles are weak and tire easily.

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Before you take Neostigmine Bromide Tablets, your doctor will take special care if any of the following apply to you:

•    You suffer from asthma

•    You have a stomach ulcer

•    You suffer from epilepsy (fits)

•    You suffer from Parkinson's disease

. You have been told you have an irritability of the vagus nerve which may cause excessive contractions of the bowels fell your doctor if any of these apply to you._

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Other uses

• Adults - 1 to 2 tablets • Children - one quarter to 1 tablet

If you think you have taken more Neostigmine Bromide Tablets than you should have

if you have accidentally taken more than the prescribed dose, tell your doctor or pharmacist immediately. Take any remaining tablets or this leaflet with you so that the medical staff know exactly what you have taken.

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3. HOW TO TAKE NEOSTIGMINE BROMIDE TABLETS

Neostigmine Bromide Tablets should be swallowed with a glass of water.

Myasthenia gravis

•    The normal adult and teenage dose varies from person to person, usually between 5 and 20 tablets per day, with 1 or 2 tablets being taken at

a time.

•    Children under 6 - usually start with half a tablet.

•    Children 6 to 12 years - one tablet, with a total dose up to 6 tablets per day

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laking other medicines

Please tell your doctor if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription.

Neostigmine Bromide Tablets should not be used at the same time as

•    Anaesthetics such as halothane, cyclopropane

•    Drugs used to relax muscles during surgery such as suxamethonium

□ ALLIANCE

Neostigmine

Bromide

Tablets 15 mg

140 tablets

To be taken by mouth. Use only as directed by a physician. Each tablet contains 15 mg of neostigmine bromide. Excipients include lactose. See leaflet for further information. Do not store above 30°C. Protect from light.

KEEP OUT OF REACH AND SIGHT OF CHILDREN.

PL 16853/0142

MA Holder: Alliance Pharmaceuticals Limited, Avonbridge House, Bath Road, Chippenham, Wiltshire, SN15 2BB, UK

Base label

6. FURTHER INFORMATION

The active substance is Neostigmine Bromide. Each tablet contains 15mg of Neostigmine Bromide.

The other ingredients are lactose, maize starch, talc and magnesium stearate

Contents of pack

Each container holds 140 tablets._

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» Keep this leaflet. You may need to read it again.

» if you have any further questions, ask your doctor or pharmacist.

» This medicine has been prescribed for you. Do not pass it on to others.

it may harm them, even if their symptoms are the same as yours.

» if any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

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They are also used when the normal movements of the intestine are absent and for the treatment of urinary retention after surgery.

2. BEFORE YOU TAKE NEOSTIGMINE BROMIDE TABLETS You should not take these tablets if:

• You have a blockage in your intestine which may cause vomiting, abdominal pain and swelling

» You have difficulty passing water_

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If you have any further questions on the use of this product ask your doctor or pharmacist

4. POSSIBLE SIDE EFFECTS

Like all medicines these tablets can sometimes cause side-effects, although not everybody gets them. All medicines can cause allergic reactions although serious allergic reactions are very rare. Any sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (especially of your whole body) should be reported to your doctor immediately.

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The likely signs of an overdose may include; stomach cramps, diarrhoea, nausea, vomiting and increased production of saliva.

If you think you have missed a dose of Neostigmine Bromide Tablets

If you think that you may have missed a dose, take it as soon as you remember. If it is nearly time for the next dose, wait until the next dose and go back to your regular dosing schedule. Do not take a double dose.

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• You know that you are allergic to Neostigmine Bromide or any of the other ingredients in Section 6 of this leaflet

Make sure your doctor knows if any of these apply to you before you take these tablets.

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Pregnancy and breast feeding

Please tell your doctor if you are or think you may be pregnant or are planning to become pregnant. Although there are no known untoward effects from taking these tablets, your doctor will advise the correct course of treatment.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

These tablets should not usually affect your ability to drive or use machines. If they make you feel ill, wait until the symptoms have worn off before driving or using machines.

Important information about some of the ingredients in Neostigmine Bromide Tablets

These tablets contain lactose, if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product._

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