Drug interactions
Atracurium + OnabotulinumtoxinA
Severity: Moderate
Atracurium and OnabotulinumtoxinA: moderate 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
Neuromuscular blocking agents can add to the muscle-weakening effect of botulinum toxin. This may cause excessive or prolonged weakness, including in muscles distant from the injection site if systemic spread occurs.
What this interaction means in plain words
Atracurium and OnabotulinumtoxinA can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Atracurium belongs to Musculoskeletal; OnabotulinumtoxinA belongs to Musculoskeletal.
Why it happens
Additive impairment of neuromuscular transmission, with botulinum toxin acting presynaptically and atracurium blocking postsynaptic nicotinic receptors.
What to do
Monitor neuromuscular function closely, ideally with train-of-four, and be prepared to extend ventilatory support if the patient has recently received botulinum toxin. Use reduced or titrated neuromuscular blocker doses.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Atracurium
Other interactions of OnabotulinumtoxinA
Frequently asked questions
Can I take Atracurium with OnabotulinumtoxinA?
MediHelp rates the interaction as moderate. Atracurium and OnabotulinumtoxinA can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Neuromuscular blocking agents can add to the muscle-weakening effect of botulinum toxin. This may cause excessive or prolonged weakness, including in muscles distant from the injection site if systemic spread occurs.
How serious is the interaction between Atracurium and OnabotulinumtoxinA?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor neuromuscular function closely, ideally with train-of-four, and be prepared to extend ventilatory support if the patient has recently received botulinum toxin. Use reduced or titrated neuromuscular blocker doses.
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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