Drug interactions
Physostigmine + Succinylcholine
Severity: Moderate
Physostigmine 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
Physostigmine inhibits cholinesterases and can prolong the depolarizing block of succinylcholine, delaying recovery and potentially causing prolonged paralysis. Because succinylcholine is metabolized by plasma cholinesterase, reduced enzyme activity increases its effect.
What this interaction means in plain words
Physostigmine 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.
Why it happens
Cholinesterase inhibition reduces succinylcholine hydrolysis and increases acetylcholine at the endplate.
What to do
Avoid giving physostigmine before or during succinylcholine use when possible. If combined, monitor neuromuscular function and be ready to provide ventilatory support.
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
Frequently asked questions
Can I take Physostigmine with Succinylcholine?
MediHelp rates the interaction as moderate. Physostigmine 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. Physostigmine inhibits cholinesterases and can prolong the depolarizing block of succinylcholine, delaying recovery and potentially causing prolonged paralysis. Because succinylcholine is metabolized by plasma cholinesterase, reduced enzyme activity increases its effect.
How serious is the interaction between Physostigmine 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: Avoid giving physostigmine before or during succinylcholine use when possible. If combined, monitor neuromuscular function and be ready to provide ventilatory support.
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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