Drug interactions
Donepezil transdermal + Rocuronium
Severity: Moderate
Donepezil transdermal 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
Donepezil is a cholinesterase inhibitor that raises acetylcholine at the neuromuscular junction, which can oppose nondepolarizing blockers such as rocuronium. Response to rocuronium may be reduced or less predictable during anesthesia.
What this interaction means in plain words
Donepezil transdermal 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.
Why it happens
Cholinesterase inhibition increases acetylcholine, pharmacologically antagonizing competitive nondepolarizing neuromuscular blockade.
What to do
Monitor neuromuscular blockade with train-of-four and adjust rocuronium dosing to effect. Inform the anesthesia team of donepezil use before surgery.
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 Rocuronium
Frequently asked questions
Can I take Donepezil transdermal with Rocuronium?
MediHelp rates the interaction as moderate. Donepezil transdermal 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. Donepezil is a cholinesterase inhibitor that raises acetylcholine at the neuromuscular junction, which can oppose nondepolarizing blockers such as rocuronium. Response to rocuronium may be reduced or less predictable during anesthesia.
How serious is the interaction between Donepezil transdermal 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: Monitor neuromuscular blockade with train-of-four and adjust rocuronium dosing to effect. Inform the anesthesia team of donepezil use before surgery.
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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