Drug interactions
Atracurium + Tobramycin
Severity: Major
Atracurium and Tobramycin: 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
Tobramycin has neuromuscular blocking activity that potentiates nondepolarising blockers. This can prolong paralysis and cause respiratory depression or apnoea.
What this interaction means in plain words
Atracurium and Tobramycin 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; Tobramycin belongs to Anti Bacterial.
Why it happens
Aminoglycoside inhibition of presynaptic acetylcholine release and reduced postsynaptic sensitivity, additive to atracurium.
What to do
Monitor train-of-four and reduce atracurium doses as needed. Ensure ventilatory support and complete recovery before extubation.
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 Atracurium
Other interactions of Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Bacitracin + Tobramycin Major
Frequently asked questions
Can I take Atracurium with Tobramycin?
MediHelp rates the interaction as major. Atracurium and Tobramycin 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. Tobramycin has neuromuscular blocking activity that potentiates nondepolarising blockers. This can prolong paralysis and cause respiratory depression or apnoea.
How serious is the interaction between Atracurium and Tobramycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor train-of-four and reduce atracurium doses as needed. Ensure ventilatory support and complete recovery before extubation.
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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