Drug interactions
Polymyxin b + Succinylcholine
Severity: Major
Polymyxin b and Succinylcholine: major interaction.
Last updated Sources: US FDA label
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
Polymyxin B has neuromuscular blocking properties that can potentiate neuromuscular blockers, especially with parenteral or irrigation use. Succinylcholine paralysis may be prolonged, with delayed return of spontaneous breathing. Calcium may only partly reverse the effect.
What this interaction means in plain words
Polymyxin b 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.
Polymyxin b belongs to Anti Bacterial; Succinylcholine belongs to Musculoskeletal.
Why it happens
Polymyxin B impairs neuromuscular transmission through presynaptic and postsynaptic effects, adding to depolarizing blockade.
What to do
Avoid combining where possible, or use quantitative neuromuscular monitoring with ventilatory support readily available. Do not rely on neostigmine or calcium alone to reverse the block.
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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References
Other interactions of Succinylcholine
Other interactions of Polymyxin b
- Cidofovir + Polymyxin b Contraindicated
- Colistin + Polymyxin b Contraindicated
- Acyclovir + Polymyxin b Major
- Adefovir + Polymyxin b Major
- Amikacin + Polymyxin b Major
- Amphotericin b + Polymyxin b Major
Frequently asked questions
Can I take Polymyxin b with Succinylcholine?
MediHelp rates the interaction as major. Polymyxin b 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. Polymyxin B has neuromuscular blocking properties that can potentiate neuromuscular blockers, especially with parenteral or irrigation use. Succinylcholine paralysis may be prolonged, with delayed return of spontaneous breathing. Calcium may only partly reverse the effect.
How serious is the interaction between Polymyxin b 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 combining where possible, or use quantitative neuromuscular monitoring with ventilatory support readily available. Do not rely on neostigmine or calcium alone to reverse the block.
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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