Drug interactions
Sacubitril / valsartan + Succinylcholine
Severity: Moderate
Sacubitril / valsartan 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
Succinylcholine causes potassium release from muscle, and valsartan reduces aldosterone-mediated potassium excretion, so serum potassium can rise further. In patients with renal impairment, heart failure or other risk factors, this may result in clinically significant hyperkalemia and arrhythmia around the time of anesthesia.
What this interaction means in plain words
Sacubitril / valsartan 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
Additive hyperkalemia from depolarization-induced potassium efflux with succinylcholine and angiotensin receptor blockade reducing renal potassium excretion.
What to do
Check baseline serum potassium and renal function before surgery and monitor potassium and ECG after succinylcholine in at-risk patients. Consider a non-depolarizing neuromuscular blocker if baseline potassium is elevated.
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 Sacubitril / valsartan with Succinylcholine?
MediHelp rates the interaction as moderate. Sacubitril / valsartan 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. Succinylcholine causes potassium release from muscle, and valsartan reduces aldosterone-mediated potassium excretion, so serum potassium can rise further. In patients with renal impairment, heart failure or other risk factors, this may result in clinically significant hyperkalemia and arrhythmia around the time of anesthesia.
How serious is the interaction between Sacubitril / valsartan 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: Check baseline serum potassium and renal function before surgery and monitor potassium and ECG after succinylcholine in at-risk patients. Consider a non-depolarizing neuromuscular blocker if baseline potassium is elevated.
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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