Drug interactions
Cisatracurium + Polymyxin b
Severity: Major
Cisatracurium and Polymyxin b: major interaction.
Last updated Sources: US FDA label
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
Polymyxin B has its own neuromuscular blocking activity and can intensify and prolong paralysis from non-depolarizing blockers such as cisatracurium. This may cause prolonged respiratory muscle weakness or apnea, particularly in the perioperative setting or when renal function is reduced.
What this interaction means in plain words
Cisatracurium and Polymyxin b 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.
Cisatracurium belongs to Musculoskeletal; Polymyxin b belongs to Anti Bacterial.
Why it happens
Additive neuromuscular blockade through presynaptic inhibition of acetylcholine release and reduced postsynaptic sensitivity caused by polymyxin B.
What to do
Avoid concurrent use where an alternative antibiotic is suitable; if needed, monitor neuromuscular function with train-of-four and ensure ventilatory support is available. Reduce cisatracurium dosing and anticipate delayed recovery.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cisatracurium and Polymyxin b, 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.
References
Other interactions of Cisatracurium
Other interactions of Polymyxin b
- Cidofovir + Polymyxin b Contraindicated
- Colistin + Polymyxin b Contraindicated
- Acyclovir + Polymyxin b Major
- Adefovir + Polymyxin b Major
- Amikacin + Polymyxin b Major
- Amphotericin b + Polymyxin b Major
Frequently asked questions
Can I take Cisatracurium with Polymyxin b?
MediHelp rates the interaction as major. Cisatracurium and Polymyxin b 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. Polymyxin B has its own neuromuscular blocking activity and can intensify and prolong paralysis from non-depolarizing blockers such as cisatracurium. This may cause prolonged respiratory muscle weakness or apnea, particularly in the perioperative setting or when renal function is reduced.
How serious is the interaction between Cisatracurium and Polymyxin b?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where an alternative antibiotic is suitable; if needed, monitor neuromuscular function with train-of-four and ensure ventilatory support is available. Reduce cisatracurium dosing and anticipate delayed recovery.
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.
