Drug interactions
Rivastigmine + Succinylcholine
Severity: Moderate
Rivastigmine 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
Rivastigmine inhibits both acetylcholinesterase and butyrylcholinesterase (plasma cholinesterase), which can slow succinylcholine breakdown and prolong paralysis. The label warns that rivastigmine may exaggerate the effects of succinylcholine-type muscle relaxants.
What this interaction means in plain words
Rivastigmine 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.
Rivastigmine belongs to Central Nervous System; Succinylcholine belongs to Musculoskeletal.
Why it happens
Inhibition of plasma cholinesterase reduces succinylcholine metabolism, prolonging depolarizing blockade.
What to do
Inform the anesthesia team of rivastigmine use. Monitor neuromuscular function with a nerve stimulator and be prepared for prolonged 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
Other interactions of Rivastigmine
Frequently asked questions
Can I take Rivastigmine with Succinylcholine?
MediHelp rates the interaction as moderate. Rivastigmine 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. Rivastigmine inhibits both acetylcholinesterase and butyrylcholinesterase (plasma cholinesterase), which can slow succinylcholine breakdown and prolong paralysis. The label warns that rivastigmine may exaggerate the effects of succinylcholine-type muscle relaxants.
How serious is the interaction between Rivastigmine 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: Inform the anesthesia team of rivastigmine use. Monitor neuromuscular function with a nerve stimulator and be prepared for prolonged 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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