Drug interactions
Atracurium + Pyridostigmine
Severity: Moderate
Atracurium and Pyridostigmine: 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
Pyridostigmine is an acetylcholinesterase inhibitor and opposes the effect of nondepolarizing blockers such as atracurium. This can lead to resistance to neuromuscular blockade or faster recovery, so higher doses of atracurium may be needed in patients taking pyridostigmine.
What this interaction means in plain words
Atracurium and Pyridostigmine 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; Pyridostigmine belongs to Central Nervous System.
Why it happens
Inhibition of acetylcholinesterase raises acetylcholine at the neuromuscular junction, pharmacodynamically antagonizing competitive blockade.
What to do
Monitor neuromuscular blockade with train-of-four and titrate atracurium to effect. In myasthenia gravis, anticipate altered sensitivity and plan the perioperative pyridostigmine regimen with the anesthesiologist.
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 Pyridostigmine
Frequently asked questions
Can I take Atracurium with Pyridostigmine?
MediHelp rates the interaction as moderate. Atracurium and Pyridostigmine 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. Pyridostigmine is an acetylcholinesterase inhibitor and opposes the effect of nondepolarizing blockers such as atracurium. This can lead to resistance to neuromuscular blockade or faster recovery, so higher doses of atracurium may be needed in patients taking pyridostigmine.
How serious is the interaction between Atracurium and Pyridostigmine?
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 blockade with train-of-four and titrate atracurium to effect. In myasthenia gravis, anticipate altered sensitivity and plan the perioperative pyridostigmine regimen with the anesthesiologist.
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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