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Physostol: Full Drug Profile

Medically reviewed by Min Clinic Staff | Updated: January 2026

Physostol - General Information

A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe anticholinergic toxicity. [PubChem]

 

Pharmacology of Physostol

Physostol is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor which effectively increases the concentration of acetylcholine at the sites of cholinergic transmission. Physostol is used to treat glaucoma. Because it crosses the blood-brain barrier, it is also used to treat the central nervous system effects of atropine overdose and other anticholinergic drug overdoses. Physostol can reverse both central and peripheral anticholinergia.

 

Physostol for patients

 

Physostol Interactions

No information provided.

 

Physostol Contraindications

Physostigmine Salicylate Injection should not be used in the presence of asthma, gangrene, diabetes, cardiovascular disease, mechanical obstruction of the intestine or urogenital tract or any vagotonic state, and in patients receiving choline esters and depolarizing neuromuscular blocking agents (decamethonium, succinyicholine).

For post-anesthesia, the concomitant use of atropine with physostigmine salicylate is not recommended, since the atropine antagonizes the action of physostigmine.

 

Additional information about Physostol

Physostol Indication

For the treatment of glaucoma, and in the treatment of severe anticholinergic toxicity.

Mechanism Of Action
By interfering with the metabolism of acetylcholine, physostigmine indirectly stimulates both nicotinic and muscarinic receptors.
Generic Name
Physostigmine
Synonyms
Eserolein, Methylcarbamate; Erserine; Eserine; Eserine Salicylate; Eserine Sulfate; Isopto Eserine
Drug Category
Cholinesterase Inhibitors; Miotics
Drug Type
Small Molecule; Approved
Other Brand Names containing Physostigmine
Antilirium; Esromiotin; Ezerin; Fysostigmin; Physostol;
Toxicity (Overdose)
Side effects include increased sweating, loss of bladder control, muscle weakness, nausea, vomiting, diarrhea, or stomach cramps or pain, shortness of breath, tightness in chest, or wheezing, slow or irregular heartbeat, unusual tiredness or weakness, watering of mouth, blurred vision or change in near or distant vision, and eye pain.
Biotransformation
Quickly hydrolyzed by cholinesterases
Dosage Forms of Physostol
Injection, solution Intramuscular
Chemical IUPAC Name
[(3aR,8bS)-3,4,8b-trimethyl-2,3a-dihydro-1H-pyrrolo[2,3-b]indol-7-yl] N-methylcarbamate
Chemical Formula
C15H21N3O2
Organisms Affected
Humans and other mammals