Bacitracin-neomycin-polymyxin + Cisatracurium

MediHelp rates the interaction as major. Bacitracin-neomycin-polymyxin and Cisatracurium 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 and neomycin have intrinsic neuromuscular blocking activity and can potentiate non-depolarizing muscle relaxants. This may prolong paralysis and delay recovery of spontaneous breathing. The risk is mainly with systemic or irrigation use and is low with intact-skin topical use.

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 systemic, irrigation or large-area combination antibiotic exposure during neuromuscular blockade where possible. If used, monitor neuromuscular function with train-of-four and ensure ventilatory support is available.

MediHelp also lists interactions of Bacitracin-neomycin-polymyxin with, for example, Allogeneic cultured keratinocytes / fibroblasts in bovine collagen, Atracurium, Capreomycin. The full list is on the Bacitracin-neomycin-polymyxin page.