Drug interactions
Amikacin + OnabotulinumtoxinA
Severity: Major
Amikacin and OnabotulinumtoxinA: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Aminoglycosides can impair neuromuscular transmission and may amplify the effect of botulinum toxin. This can cause excessive muscle weakness, including swallowing or breathing difficulty, beyond the injected area.
What this interaction means in plain words
Amikacin and OnabotulinumtoxinA can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amikacin belongs to Anti Bacterial; OnabotulinumtoxinA belongs to Musculoskeletal.
Why it happens
Additive impairment of neuromuscular transmission through reduced presynaptic acetylcholine release.
What to do
Avoid combining where possible. If necessary, monitor for generalized weakness and respiratory or swallowing compromise after injection.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amikacin
- Amikacin + Cidofovir Contraindicated
- Adefovir + Amikacin Major
- Amikacin + Amphotericin b Major
- Amikacin + Amphotericin b deoxycholate Major
- Amikacin + Atracurium Major
- Amikacin + Bacitracin Major
Other interactions of OnabotulinumtoxinA
- Gentamicin + OnabotulinumtoxinA Major
- OnabotulinumtoxinA + Streptomycin Major
- Atracurium + OnabotulinumtoxinA Moderate
- Atropine + OnabotulinumtoxinA Moderate
- Baclofen + OnabotulinumtoxinA Moderate
- Benztropine + OnabotulinumtoxinA Moderate
Frequently asked questions
Can I take Amikacin with OnabotulinumtoxinA?
MediHelp rates the interaction as major. Amikacin and OnabotulinumtoxinA can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Aminoglycosides can impair neuromuscular transmission and may amplify the effect of botulinum toxin. This can cause excessive muscle weakness, including swallowing or breathing difficulty, beyond the injected area.
How serious is the interaction between Amikacin and OnabotulinumtoxinA?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible. If necessary, monitor for generalized weakness and respiratory or swallowing compromise after injection.
What other medicines interact with Amikacin?
MediHelp also lists interactions of Amikacin with, for example, Cidofovir, Adefovir, Amphotericin b. The full list is on the Amikacin page.
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