Drug interactions
Cisatracurium + Donepezil
Severity: Moderate
Cisatracurium and Donepezil: 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
Donepezil, a cholinesterase inhibitor, may reduce the effect of non-depolarizing blockers like cisatracurium by raising acetylcholine at the neuromuscular junction. This can cause resistance to blockade or need for higher doses, though cisatracurium is less dependent on cholinesterase than some agents.
What this interaction means in plain words
Cisatracurium and Donepezil 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.
Cisatracurium belongs to Musculoskeletal; Donepezil belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism: acetylcholinesterase inhibition increases acetylcholine, which competes with the non-depolarizing blocker at nicotinic receptors.
What to do
Monitor neuromuscular function with train-of-four and titrate cisatracurium to effect. Inform the anesthesia team of chronic donepezil use before surgery.
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 Cisatracurium
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Cisatracurium with Donepezil?
MediHelp rates the interaction as moderate. Cisatracurium and Donepezil 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. Donepezil, a cholinesterase inhibitor, may reduce the effect of non-depolarizing blockers like cisatracurium by raising acetylcholine at the neuromuscular junction. This can cause resistance to blockade or need for higher doses, though cisatracurium is less dependent on cholinesterase than some agents.
How serious is the interaction between Cisatracurium and Donepezil?
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 with train-of-four and titrate cisatracurium to effect. Inform the anesthesia team of chronic donepezil use before surgery.
What other medicines interact with Cisatracurium?
MediHelp also lists interactions of Cisatracurium with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Benzhydrocodone / acetaminophen. The full list is on the Cisatracurium page.
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