Drug interactions
Cisatracurium + Rocuronium
Severity: Moderate
Cisatracurium and Rocuronium: 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
Giving two non-depolarizing neuromuscular blockers together produces additive or synergistic neuromuscular blockade. Onset, depth and duration of paralysis may differ from either drug used alone, and prolonged paralysis or residual block after surgery may occur.
What this interaction means in plain words
Cisatracurium and Rocuronium 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; Rocuronium belongs to Musculoskeletal.
Why it happens
Both drugs competitively antagonize acetylcholine at nicotinic receptors of the motor end plate, producing additive pharmacodynamic effects.
What to do
Titrate doses using quantitative train-of-four monitoring and reduce subsequent doses of the second agent as needed. Confirm adequate recovery before extubation, with reversal agent if required.
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
Other interactions of Rocuronium
Frequently asked questions
Can I take Cisatracurium with Rocuronium?
MediHelp rates the interaction as moderate. Cisatracurium and Rocuronium 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. Giving two non-depolarizing neuromuscular blockers together produces additive or synergistic neuromuscular blockade. Onset, depth and duration of paralysis may differ from either drug used alone, and prolonged paralysis or residual block after surgery may occur.
How serious is the interaction between Cisatracurium and Rocuronium?
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 as needed. Confirm adequate recovery before extubation, with reversal agent if required.
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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