Drug interactions
Cisatracurium + OnabotulinumtoxinA
Severity: Moderate
Cisatracurium 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 blockers may add to the effect of botulinum toxin, potentially producing excessive or generalized muscle weakness. This is most relevant when toxin has been given recently or in large doses.
What this interaction means in plain words
Cisatracurium 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.
Cisatracurium belongs to Musculoskeletal; OnabotulinumtoxinA belongs to Musculoskeletal.
Why it happens
Additive impairment of neuromuscular transmission: botulinum toxin blocks presynaptic acetylcholine release while cisatracurium blocks postsynaptic nicotinic receptors.
What to do
Use reduced initial doses of cisatracurium with train-of-four monitoring in patients recently given botulinum toxin. Watch for prolonged weakness and respiratory or swallowing difficulty.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cisatracurium and OnabotulinumtoxinA, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Cisatracurium
Other interactions of OnabotulinumtoxinA
Frequently asked questions
Can I take Cisatracurium with OnabotulinumtoxinA?
MediHelp rates the interaction as moderate. Cisatracurium 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 blockers may add to the effect of botulinum toxin, potentially producing excessive or generalized muscle weakness. This is most relevant when toxin has been given recently or in large doses.
How serious is the interaction between Cisatracurium 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: Use reduced initial doses of cisatracurium with train-of-four monitoring in patients recently given botulinum toxin. Watch for prolonged weakness and respiratory or swallowing difficulty.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
