Drug interactions
Colistimethate sodium + Sodium citrate
Severity: Major
Colistimethate sodium and Sodium citrate: major 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
Colistimethate can cause neuromuscular blockade, and citrate may add to this effect through calcium binding. Respiratory muscle weakness or apnea is possible.
What this interaction means in plain words
Colistimethate sodium and Sodium citrate 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.
Why it happens
Additive impairment of neuromuscular transmission; citrate chelates calcium and colistimethate has a curare-like effect.
What to do
Avoid concurrent use where possible. If it is required, monitor respiratory function and neuromuscular status closely.
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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Other interactions of Colistimethate sodium
Frequently asked questions
Can I take Colistimethate sodium with Sodium citrate?
MediHelp rates the interaction as major. Colistimethate sodium and Sodium citrate 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. Colistimethate can cause neuromuscular blockade, and citrate may add to this effect through calcium binding. Respiratory muscle weakness or apnea is possible.
How serious is the interaction between Colistimethate sodium and Sodium citrate?
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 possible. If it is required, monitor respiratory function and neuromuscular status closely.
What other medicines interact with Colistimethate sodium?
MediHelp also lists interactions of Colistimethate sodium with, for example, Succinylcholine. The full list is on the Colistimethate sodium page.
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