Drug interactions
Neomycin + Rapacuronium
Severity: Major
Neomycin and Rapacuronium: 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
Aminoglycosides can enhance non-depolarizing neuromuscular blockade, and oral neomycin may be absorbed with bowel disease or when high doses are used. This may cause prolonged paralysis and respiratory depression, and rapacuronium has been withdrawn from the market.
What this interaction means in plain words
Neomycin 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
Aminoglycosides reduce presynaptic acetylcholine release and postsynaptic sensitivity, adding to neuromuscular blockade.
What to do
Use an alternative neuromuscular blocker where possible, and monitor neuromuscular function with train-of-four with ventilatory support 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 Neomycin
- Amikacin + Neomycin Major
- Amphotericin b deoxycholate + Neomycin Major
- Capreomycin + Neomycin Major
- Cidofovir + Neomycin Major
- Colistin + Neomycin Major
- Ethacrynic acid + Neomycin Major
Frequently asked questions
Can I take Neomycin with Rapacuronium?
MediHelp rates the interaction as major. Neomycin 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. Aminoglycosides can enhance non-depolarizing neuromuscular blockade, and oral neomycin may be absorbed with bowel disease or when high doses are used. This may cause prolonged paralysis and respiratory depression, and rapacuronium has been withdrawn from the market.
How serious is the interaction between Neomycin 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: Use an alternative neuromuscular blocker where possible, and monitor neuromuscular function with train-of-four with ventilatory support available.
What other medicines interact with Neomycin?
MediHelp also lists interactions of Neomycin with, for example, Amikacin, Amphotericin b deoxycholate, Capreomycin. The full list is on the Neomycin page.
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