Drug interactions
Succinylcholine + Tobramycin
Severity: Major
Succinylcholine and Tobramycin: 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
Tobramycin can impair neuromuscular transmission and may enhance or prolong succinylcholine-induced paralysis. Prolonged apnea and delayed recovery of respiratory function have been reported with aminoglycosides and neuromuscular blockers.
What this interaction means in plain words
Succinylcholine and Tobramycin 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.
Succinylcholine belongs to Musculoskeletal; Tobramycin belongs to Anti Bacterial.
Why it happens
Aminoglycosides reduce presynaptic acetylcholine release and decrease postsynaptic sensitivity, adding to neuromuscular blockade.
What to do
Monitor neuromuscular blockade with a nerve stimulator and keep ventilatory support available until full recovery. Consider an alternative antibiotic perioperatively, or time doses to avoid peak levels during surgery.
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 Succinylcholine
Other interactions of Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Succinylcholine with Tobramycin?
MediHelp rates the interaction as major. Succinylcholine and Tobramycin 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. Tobramycin can impair neuromuscular transmission and may enhance or prolong succinylcholine-induced paralysis. Prolonged apnea and delayed recovery of respiratory function have been reported with aminoglycosides and neuromuscular blockers.
How serious is the interaction between Succinylcholine and Tobramycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor neuromuscular blockade with a nerve stimulator and keep ventilatory support available until full recovery. Consider an alternative antibiotic perioperatively, or time doses to avoid peak levels during surgery.
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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