Drug interactions
Cisatracurium + Tobramycin
Severity: Major
Cisatracurium and Tobramycin: 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
Tobramycin can intensify and prolong neuromuscular blockade produced by cisatracurium. This may cause delayed recovery, respiratory depression or apnea, especially with renal impairment.
What this interaction means in plain words
Cisatracurium and Tobramycin 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; Tobramycin belongs to Anti Bacterial.
Why it happens
Aminoglycosides inhibit presynaptic acetylcholine release and reduce postsynaptic sensitivity, adding to competitive nicotinic blockade.
What to do
Use train-of-four monitoring and reduce cisatracurium doses as needed. Keep ventilatory support available until full neuromuscular 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?
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References
Other interactions of Cisatracurium
Other interactions of Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Cisatracurium with Tobramycin?
MediHelp rates the interaction as major. Cisatracurium and Tobramycin 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. Tobramycin can intensify and prolong neuromuscular blockade produced by cisatracurium. This may cause delayed recovery, respiratory depression or apnea, especially with renal impairment.
How serious is the interaction between Cisatracurium and Tobramycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use train-of-four monitoring and reduce cisatracurium doses as needed. Keep ventilatory support available until full neuromuscular 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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