Drug interactions
Colistin + Rocuronium
Severity: Major
Colistin and Rocuronium: 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
Colistin can itself cause neuromuscular blockade and may potentiate rocuronium. Prolonged paralysis and respiratory failure are possible.
What this interaction means in plain words
Colistin and Rocuronium 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 belongs to Anti Bacterial; Rocuronium belongs to Musculoskeletal.
Why it happens
Colistin reduces presynaptic acetylcholine release and stabilizes the postsynaptic membrane, adding to nicotinic blockade by rocuronium.
What to do
Avoid co-administration where possible; otherwise reduce rocuronium dose and monitor with train-of-four. Have ventilatory support available, as reversal may be incomplete.
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 Rocuronium
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 Rocuronium?
MediHelp rates the interaction as major. Colistin and Rocuronium 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 can itself cause neuromuscular blockade and may potentiate rocuronium. Prolonged paralysis and respiratory failure are possible.
How serious is the interaction between Colistin and Rocuronium?
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 co-administration where possible; otherwise reduce rocuronium dose and monitor with train-of-four. Have ventilatory support available, as reversal may be incomplete.
What other medicines interact with Rocuronium?
MediHelp also lists interactions of Rocuronium with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Capreomycin. The full list is on the Rocuronium page.
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