Drug interactions
Colistin + Rapacuronium
Severity: Major
Colistin and Rapacuronium: major interaction.
Last updated Sources: Health Canada product monograph
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
Colistin has neuromuscular blocking activity and can potentiate and prolong the effect of non-depolarizing muscle relaxants. This may cause prolonged paralysis and respiratory failure after surgery.
What this interaction means in plain words
Colistin and Rapacuronium 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
Colistin inhibits presynaptic acetylcholine release and stabilizes the postsynaptic membrane, adding to non-depolarizing neuromuscular blockade.
What to do
Avoid the combination if possible; if used, monitor neuromuscular function with train-of-four and ensure ventilatory support is available.
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 Colistin
- Colistin + Polymyxin b Contraindicated
- Amikacin + Colistin Major
- Amphotericin b deoxycholate + Colistin Major
- Amphotericin b + Colistin Major
- Atracurium + Colistin Major
- Bacitracin + Colistin Major
Frequently asked questions
Can I take Colistin with Rapacuronium?
MediHelp rates the interaction as major. Colistin and Rapacuronium 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. Colistin has neuromuscular blocking activity and can potentiate and prolong the effect of non-depolarizing muscle relaxants. This may cause prolonged paralysis and respiratory failure after surgery.
How serious is the interaction between Colistin and Rapacuronium?
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 the combination if possible; if used, monitor neuromuscular function with train-of-four and ensure ventilatory support is available.
What other medicines interact with Colistin?
MediHelp also lists interactions of Colistin with, for example, Polymyxin b, Amikacin, Amphotericin b deoxycholate. The full list is on the Colistin page.
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