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| Interactions: | Amphotericin B
Adverse Effect: enhanced muscle relaxation secondary to hypokalemia Clinical Management: Carefully monitor serum potassium concentrations in patients receiving Atracurium and amphotericin B. Clinicians should be alert to potentially enhanced muscle paralysis in these patients.
Betamethasone
Adverse Effect: Decreased atracurium effectiveness; prolonged muscle weakness and myopathyClinical Management: If concurrent therapy is required, monitor the effectiveness of atracurium and adjust the dose as required, especially in patients receiving high-dose Betamethasone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Carbamazepine
Adverse Effect: Decreased atracurium duration of action Clinical Management: Monitor patients for an appropriate clinical response to the neuromuscular blocker. Closer dosing intervals or higher doses of atracurium may be needed in patients receiving carbamazepine.
Clindamycin
Adverse Effect: enhanced and prolonged neuromuscular blockade Clinical Management: If concurrent therapy with these agents is required, closely monitor patients for excessive neuromuscular blockade. A reduction in the dose of atracurium may be advantageous. The need for respiratory support should be anticipated.
Colistin Sulphate
Adverse Effect: enhanced or prolonged neuromuscular blockade Clinical Management: Avoid concomitant use of Colistin Sulphate and Atracurium. If the combination cannot be avoided, observe patients closely for enhanced or prolonged neuromuscular blockade which may require mechanical ventilation.
Dexamethasone
Adverse Effect: decreased atracurium effectiveness; prolonged muscle weakness and myopathyClinical Management: If concurrent therapy is required, monitor the effectiveness of atracurium and adjust the dose as required, especially in patients receiving high-dose Dexamethasone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Gentamicin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Gentamicin and Atracurium if possible. Concurrent use of Gentamicin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Hydrocortisone
Adverse Effect: decreased effectiveness of non depolarising agents; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of atracurium and adjust the dose as required, especially in patients receiving high-dose Hydrocortisone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Ketamine
Adverse Effect: Increased neuromuscular blockade Clinical Management: Use atracurium and ketamine concurrently with caution. If used together, adjust the dose of atracurium and monitor patients for prolonged respiratory depression.
Lincomycin
Adverse Effect: Atracurium toxicity (respiratory depression) Clinical Management: If concurrent therapy is required, a reduction in the dose of Atracurium may be required. The need for respiratory support should be anticipated.
Neomycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Neomycin and Atracurium if possible. Concurrent use of Neomycin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Netilmicin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Netilmicin and Atracurium if possible. Concurrent use of Netilmicin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Prednisolone
Adverse Effect: decreased effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of atracurium and adjust the dose as required, especially in patients receiving high-dose Prednisolone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Procainamide
Adverse Effect: Excessive neuromuscular blockade Clinical Management: A reduction in the atracurium dose may be necessary when administered with procainamide.
Quinidine
Adverse Effect: atracurium toxicity (respiratory depression, apnea) Clinical Management: Quinidine should be avoided if possible in the immediate postoperative period when the effects of neuromuscular blockers may be present. If quinidine is utilized, the need for respiratory support should be anticipated.
Ranitidine
Adverse Effect: Antagonism of neuromuscular blockade
Sisomicin
Adverse Effect: Enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Sisomicin and Atracurium if possible. Concurrent use of Sisomicin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status. Calcium ions should be given in some form, particularly if large amounts of blood have been transfused. Edrophonium, neostigmine, or atropine may provide partial reversal of hypoventilation. As the block is reversible with time, artificial ventilation may be required and should be maintained until adequate respiration returns.
Soframycin - Ocular
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Soframycin - Ocular and Atracurium if possible. Concurrent use of Soframycin - Ocular and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Streptomycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Streptomycin and Atracurium if possible. Concurrent use of Streptomycin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Succinyl Choline
Adverse Effect: Antagonism of neuromuscular blocking activity Clinical Management: When coadministering succinylcholine and atracurium, larger than expected doses may be necessary to induce and maintain neuromuscular blockade. Monitor the patient for neuromuscular response and adjust doses accordingly.
Tobramycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Tobramycin and Atracurium if possible. Concurrent use of Tobramycin and Atracurium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Triamcinolone
Adverse Effect: decreased atracurium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of atracurium and adjust the dose as required, especially in patients receiving high-dose Triamcinolone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker. |
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