Drug interactions
Pancuronium + Phenytoin
Severity: Moderate
Pancuronium and Phenytoin: 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
Patients on long-term phenytoin often show resistance to non-depolarising neuromuscular blockers such as pancuronium, with shorter duration of action and higher dose requirements. Recovery may be faster than expected. Acute phenytoin administration may have the opposite effect.
What this interaction means in plain words
Pancuronium and Phenytoin 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.
Pancuronium belongs to Musculoskeletal; Phenytoin belongs to Central Nervous System.
Why it happens
Chronic phenytoin therapy is thought to increase clearance of the blocker and alter neuromuscular receptor sensitivity.
What to do
Monitor neuromuscular blockade with train-of-four and be prepared to increase pancuronium dose or infusion rate in chronic phenytoin users.
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 Pancuronium
Other interactions of Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicated
- Bictegravir + Phenytoin Contraindicated
- Cabotegravir + Phenytoin Contraindicated
- Doravirine + Phenytoin Contraindicated
- Elbasvir / grazoprevir + Phenytoin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Contraindicated
Frequently asked questions
Can I take Pancuronium with Phenytoin?
MediHelp rates the interaction as moderate. Pancuronium and Phenytoin 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. Patients on long-term phenytoin often show resistance to non-depolarising neuromuscular blockers such as pancuronium, with shorter duration of action and higher dose requirements. Recovery may be faster than expected. Acute phenytoin administration may have the opposite effect.
How serious is the interaction between Pancuronium and Phenytoin?
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 be prepared to increase pancuronium dose or infusion rate in chronic phenytoin users.
What other medicines interact with Pancuronium?
MediHelp also lists interactions of Pancuronium with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Capreomycin. The full list is on the Pancuronium page.
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