Drug interactions
Atracurium + Bacitracin-neomycin-polymyxin
Severity: Major
Atracurium and Bacitracin-neomycin-polymyxin: 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
Systemically absorbed polymyxin B and neomycin can have neuromuscular blocking activity and may potentiate non-depolarizing blockers. This could cause prolonged paralysis and respiratory depression. The risk with topical or irrigation use is low unless there is significant absorption from large wounds, body cavities or irrigation.
What this interaction means in plain words
Atracurium and Bacitracin-neomycin-polymyxin 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.
Atracurium belongs to Musculoskeletal; Bacitracin-neomycin-polymyxin belongs to Anti Bacterial.
Why it happens
Polymyxin B and neomycin reduce presynaptic acetylcholine release and postsynaptic sensitivity, adding to non-depolarizing neuromuscular blockade.
What to do
Avoid peritoneal or wound irrigation with these antibiotics around anesthesia where possible. Monitor neuromuscular function and be prepared for ventilatory support, noting that calcium may be needed for reversal.
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 Bacitracin-neomycin-polymyxin
- Allogeneic cultured keratinocytes / fibroblasts in bovine collagen + Bacitracin-neomycin-polymyxin Major
- Bacitracin-neomycin-polymyxin + Capreomycin Major
- Bacitracin-neomycin-polymyxin + Cidofovir Major
- Bacitracin-neomycin-polymyxin + Cisatracurium Major
- Bacitracin-neomycin-polymyxin + Pancuronium Major
- Bacitracin-neomycin-polymyxin + Rocuronium Major
Other interactions of Atracurium
Frequently asked questions
Can I take Atracurium with Bacitracin-neomycin-polymyxin?
MediHelp rates the interaction as major. Atracurium and Bacitracin-neomycin-polymyxin 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. Systemically absorbed polymyxin B and neomycin can have neuromuscular blocking activity and may potentiate non-depolarizing blockers. This could cause prolonged paralysis and respiratory depression. The risk with topical or irrigation use is low unless there is significant absorption from large wounds, body cavities or irrigation.
How serious is the interaction between Atracurium and Bacitracin-neomycin-polymyxin?
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 peritoneal or wound irrigation with these antibiotics around anesthesia where possible. Monitor neuromuscular function and be prepared for ventilatory support, noting that calcium may be needed for reversal.
What other medicines interact with Bacitracin-neomycin-polymyxin?
MediHelp also lists interactions of Bacitracin-neomycin-polymyxin with, for example, Allogeneic cultured keratinocytes / fibroblasts in bovine collagen, Capreomycin, Cidofovir. The full list is on the Bacitracin-neomycin-polymyxin page.
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