Drug interactions
Atracurium + Fosphenytoin
Severity: Minor
Atracurium and Fosphenytoin: minor 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
Chronic phenytoin therapy can shorten the duration of action and raise dose requirements of some non-depolarizing neuromuscular blockers. Atracurium is affected less than steroidal agents, but faster recovery from blockade is possible. Fosphenytoin is converted to phenytoin, so the same effect is expected.
What this interaction means in plain words
Atracurium and Fosphenytoin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Atracurium belongs to Musculoskeletal; Fosphenytoin belongs to Central Nervous System.
Why it happens
Chronic phenytoin exposure is thought to cause resistance to non-depolarizing blockers through receptor changes and possibly enhanced clearance; the effect on atracurium is variable.
What to do
Monitor neuromuscular blockade with train-of-four during anesthesia and titrate atracurium to effect. Be prepared for higher infusion requirements in patients on long-term therapy.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Atracurium
Other interactions of Fosphenytoin
- Dronedarone + Fosphenytoin Contraindicated
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
- Fosphenytoin + Lurasidone Contraindicated
- Fosphenytoin + Ranolazine Contraindicated
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Atracurium with Fosphenytoin?
MediHelp rates the interaction as minor. Atracurium and Fosphenytoin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Chronic phenytoin therapy can shorten the duration of action and raise dose requirements of some non-depolarizing neuromuscular blockers. Atracurium is affected less than steroidal agents, but faster recovery from blockade is possible. Fosphenytoin is converted to phenytoin, so the same effect is expected.
How serious is the interaction between Atracurium and Fosphenytoin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor neuromuscular blockade with train-of-four during anesthesia and titrate atracurium to effect. Be prepared for higher infusion requirements in patients on long-term therapy.
What other medicines interact with Atracurium?
MediHelp also lists interactions of Atracurium with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Benzhydrocodone / acetaminophen. The full list is on the Atracurium page.
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