Neostigmine is destroyed by plasma esterases, and the quaternary alcohol and parent compound are excreted in the urine.
Neostigmine methyl sulfate is an arylammonium sulfate salt. It has a role as an EC 18.104.22.168 (cholinesterase) inhibitor. A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.