Drug interactions
Cisatracurium + Physostigmine
Severity: Moderate
Cisatracurium and Physostigmine: 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
Physostigmine inhibits cholinesterase and can antagonize nondepolarizing blockade, so cisatracurium may be less effective or recovery faster than expected. Cholinergic effects such as bradycardia and secretions may also occur.
What this interaction means in plain words
Cisatracurium and Physostigmine 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.
Why it happens
Acetylcholinesterase inhibition increases junctional acetylcholine, competitively opposing cisatracurium.
What to do
Monitor neuromuscular function with train-of-four and titrate cisatracurium to effect. Monitor heart rate and be prepared to treat cholinergic effects.
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
Frequently asked questions
Can I take Cisatracurium with Physostigmine?
MediHelp rates the interaction as moderate. Cisatracurium and Physostigmine 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. Physostigmine inhibits cholinesterase and can antagonize nondepolarizing blockade, so cisatracurium may be less effective or recovery faster than expected. Cholinergic effects such as bradycardia and secretions may also occur.
How serious is the interaction between Cisatracurium and Physostigmine?
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. Monitor heart rate and be prepared to treat cholinergic effects.
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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