Drug interactions
Cisatracurium + Hydrocortisone
Severity: Moderate
Cisatracurium and Hydrocortisone: 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
Corticosteroids given with non-depolarizing neuromuscular blockers, particularly in critically ill patients on prolonged infusions, have been linked to acute quadriplegic myopathy. This may cause prolonged weakness and delayed weaning from ventilation.
What this interaction means in plain words
Cisatracurium and Hydrocortisone 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; Hydrocortisone belongs to Endocrine.
Why it happens
Additive muscle injury and neuromuscular dysfunction from steroids with prolonged neuromuscular blockade.
What to do
Use the lowest effective dose and shortest duration of blockade and monitor depth of block with train-of-four. Assess for persistent weakness and check creatine kinase if suspected.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
Other interactions of Cisatracurium
Frequently asked questions
Can I take Cisatracurium with Hydrocortisone?
MediHelp rates the interaction as moderate. Cisatracurium and Hydrocortisone 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. Corticosteroids given with non-depolarizing neuromuscular blockers, particularly in critically ill patients on prolonged infusions, have been linked to acute quadriplegic myopathy. This may cause prolonged weakness and delayed weaning from ventilation.
How serious is the interaction between Cisatracurium and Hydrocortisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective dose and shortest duration of blockade and monitor depth of block with train-of-four. Assess for persistent weakness and check creatine kinase if suspected.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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