Drug interactions
Atracurium + Magnesium sulfate
Severity: Major
Atracurium and Magnesium sulfate: major interaction.
Last updated Sources: US FDA label
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
Parenteral magnesium sulfate enhances and prolongs the effect of nondepolarizing neuromuscular blockers such as atracurium. This can delay recovery of muscle strength and cause respiratory compromise after surgery.
What this interaction means in plain words
Atracurium and Magnesium sulfate 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.
Why it happens
Magnesium reduces presynaptic acetylcholine release and decreases postsynaptic sensitivity, adding to competitive nicotinic blockade.
What to do
Reduce the atracurium dose and monitor neuromuscular function with train-of-four, confirming full recovery before extubation; be prepared to provide ventilatory support.
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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References
Other interactions of Atracurium
Frequently asked questions
Can I take Atracurium with Magnesium sulfate?
MediHelp rates the interaction as major. Atracurium and Magnesium sulfate 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. Parenteral magnesium sulfate enhances and prolongs the effect of nondepolarizing neuromuscular blockers such as atracurium. This can delay recovery of muscle strength and cause respiratory compromise after surgery.
How serious is the interaction between Atracurium and Magnesium sulfate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the atracurium dose and monitor neuromuscular function with train-of-four, confirming full recovery before extubation; be prepared to provide ventilatory support.
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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