Drug interactions
OnabotulinumtoxinA + Succinylcholine
Severity: Moderate
OnabotulinumtoxinA and Succinylcholine: 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
Neuromuscular blockers can potentiate the effects of botulinum toxin, leading to excessive weakness. Because botulinum toxin may spread, the effect can occasionally become generalized, including swallowing or breathing difficulty. The risk is greatest soon after toxin injection and with high doses.
What this interaction means in plain words
OnabotulinumtoxinA and Succinylcholine 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.
OnabotulinumtoxinA belongs to Musculoskeletal; Succinylcholine belongs to Musculoskeletal.
Why it happens
Presynaptic blockade of acetylcholine release by the toxin adds to postsynaptic depolarizing blockade.
What to do
Tell the anesthesia team about recent botulinum toxin treatment and use the lowest effective neuromuscular blocker dose. Monitor neuromuscular function and respiratory status closely.
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 Succinylcholine
Other interactions of OnabotulinumtoxinA
Frequently asked questions
Can I take OnabotulinumtoxinA with Succinylcholine?
MediHelp rates the interaction as moderate. OnabotulinumtoxinA and Succinylcholine 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. Neuromuscular blockers can potentiate the effects of botulinum toxin, leading to excessive weakness. Because botulinum toxin may spread, the effect can occasionally become generalized, including swallowing or breathing difficulty. The risk is greatest soon after toxin injection and with high doses.
How serious is the interaction between OnabotulinumtoxinA and Succinylcholine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Tell the anesthesia team about recent botulinum toxin treatment and use the lowest effective neuromuscular blocker dose. Monitor neuromuscular function and respiratory status closely.
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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