Drug interactions
Polymyxin b + Vecuronium
Severity: Major
Polymyxin b and Vecuronium: 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
Polymyxin B has neuromuscular blocking properties and can enhance and prolong vecuronium paralysis. This may cause delayed recovery, respiratory depression or apnea, and the effect may not be fully reversed by neostigmine or calcium.
What this interaction means in plain words
Polymyxin b and Vecuronium 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; Vecuronium belongs to Musculoskeletal.
Why it happens
Polymyxin B blocks prejunctional acetylcholine release and stabilizes the postsynaptic membrane, adding to nondepolarizing blockade.
What to do
Avoid concurrent use if alternatives exist; otherwise reduce vecuronium dosing, monitor with train-of-four and ensure prolonged ventilatory support is 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 Vecuronium
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 Vecuronium?
MediHelp rates the interaction as major. Polymyxin b and Vecuronium 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 and can enhance and prolong vecuronium paralysis. This may cause delayed recovery, respiratory depression or apnea, and the effect may not be fully reversed by neostigmine or calcium.
How serious is the interaction between Polymyxin b and Vecuronium?
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 concurrent use if alternatives exist; otherwise reduce vecuronium dosing, monitor with train-of-four and ensure prolonged ventilatory support is available.
What other medicines interact with Vecuronium?
MediHelp also lists interactions of Vecuronium with, for example, Amikacin, Bacitracin-neomycin-polymyxin, Capreomycin. The full list is on the Vecuronium page.
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