Drug interactions
Cisatracurium + Rapacuronium
Severity: Moderate
Cisatracurium and Rapacuronium: 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
Both are nondepolarizing neuromuscular blockers, so giving them together produces additive or synergistic muscle relaxation. The duration and depth of paralysis may be greater than expected from either drug alone. Rapacuronium has been withdrawn from most markets.
What this interaction means in plain words
Cisatracurium and Rapacuronium 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
Additive competitive antagonism of nicotinic acetylcholine receptors at the neuromuscular junction.
What to do
Titrate doses using quantitative train-of-four monitoring and reduce subsequent doses of the second agent. Ensure ventilatory support and reversal capability until full recovery.
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 Rapacuronium?
MediHelp rates the interaction as moderate. Cisatracurium and Rapacuronium 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. Both are nondepolarizing neuromuscular blockers, so giving them together produces additive or synergistic muscle relaxation. The duration and depth of paralysis may be greater than expected from either drug alone. Rapacuronium has been withdrawn from most markets.
How serious is the interaction between Cisatracurium and Rapacuronium?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate doses using quantitative train-of-four monitoring and reduce subsequent doses of the second agent. Ensure ventilatory support and reversal capability until full 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.
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