Drug interactions
Echothiophate iodide + Succinylcholine
Severity: Major
Echothiophate iodide and Succinylcholine: 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
Echothiophate is an irreversible cholinesterase inhibitor that depletes plasma cholinesterase activity, which is the enzyme that normally breaks down succinylcholine. Neuromuscular blockade can therefore be markedly prolonged, with extended paralysis and apnea. The effect may persist for weeks after the last echothiophate dose.
What this interaction means in plain words
Echothiophate iodide and Succinylcholine 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
Irreversible inhibition of plasma pseudocholinesterase reduces hydrolysis of succinylcholine, prolonging its depolarizing block.
What to do
Avoid succinylcholine in patients using echothiophate and choose a non-depolarizing neuromuscular blocker with quantitative neuromuscular monitoring. If succinylcholine is unavoidable, ensure prolonged 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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Other interactions of Succinylcholine
Frequently asked questions
Can I take Echothiophate iodide with Succinylcholine?
MediHelp rates the interaction as major. Echothiophate iodide and Succinylcholine 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. Echothiophate is an irreversible cholinesterase inhibitor that depletes plasma cholinesterase activity, which is the enzyme that normally breaks down succinylcholine. Neuromuscular blockade can therefore be markedly prolonged, with extended paralysis and apnea. The effect may persist for weeks after the last echothiophate dose.
How serious is the interaction between Echothiophate iodide and Succinylcholine?
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 succinylcholine in patients using echothiophate and choose a non-depolarizing neuromuscular blocker with quantitative neuromuscular monitoring. If succinylcholine is unavoidable, ensure prolonged ventilatory support is available.
What other medicines interact with Succinylcholine?
MediHelp also lists interactions of Succinylcholine with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Capreomycin. The full list is on the Succinylcholine page.
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