Key points

  • We recommend to consult your poison centre with the use of this antidote.
  • This antidote is only available through the Special Access Program. Accessibility may vary according to the hospital and the province.
  • The use of physostigmine is contra-indicated in mixed drug poisoning or poisoning of unknown etiology, particularly when accompanied by QRS widening or any other intraventricular conduction problem.
  • Close monitoring and careful titration is necessary to avoid cholinergic toxicity from too rapid physostigmine administration (either from repeat dosing frequency or infusions).
  • Onset of action occurs between 5 and 10 minutes after IV administration and the duration varies between 30 min and 5 hours depending on the severity of the anticholinergic poisoning to be reversed.

Last updated : 2021-08-31