cisatracurium besylate Drug Interactions

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7 DRUG INTERACTIONS

7.1 Clinically Significant Drug Interactions

Table 4 displays clinically significant drug interactions with Cisatracurium Besylate Injection.

Table 4. Clinically Significant Drug Interactions with Cisatracurium Besylate Injection
Drug or Drug Class Clinical Implications*
*
The use of peripheral nerve stimulator is strongly recommended to evaluate the level of neuromuscular blockade, to assess the need for additional doses of Cisatracurium Besylate Injection, and to determine whether adjustments need to be made to the dose with subsequent administration.
†
Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate

Succinylcholine

The use of succinylcholine prior to Cisatracurium Besylate Injection administration may decrease the time to onset of maximum neuromuscular blockade but has no effect on the duration of neuromuscular blockade.

Inhalational Anesthetics

Administration of inhalational anesthetics with nitrous oxide/oxygen for greater than 30 minutes to achieve 1.25 Minimum Alveolar Concentration (MAC) may prolong the duration of action of initial and maintenance doses of Cisatracurium Besylate Injection. This may potentiate the neuromuscular blockade.

Antibiotics†
Local anesthetics
Magnesium salts
Procainamide
Lithium
Quinidine

May prolong the neuromuscular blockade action of Cisatracurium Besylate Injection

Phenytoin, Carbamazepine

May increase resistance to the neuromuscular blockade action of Cisatracurium Besylate Injection resulting in shorter durations of neuromuscular blockade and infusion rate requirements may be higher.

7.2 Drugs Without Clinically Significant Drug Interactions With Cisatracurium Besylate Injection

In clinical studies, propofol had no effect on the duration of action or dosing requirements for cisatracurium besylate. Cisatracurium besylate is not compatible with propofol for Y-site administration.

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Drug Interactions

7 DRUG INTERACTIONS

7.1 Clinically Significant Drug Interactions

Table 4 displays clinically significant drug interactions with Cisatracurium Besylate Injection.

Table 4. Clinically Significant Drug Interactions with Cisatracurium Besylate Injection
Drug or Drug Class Clinical Implications*
*
The use of peripheral nerve stimulator is strongly recommended to evaluate the level of neuromuscular blockade, to assess the need for additional doses of Cisatracurium Besylate Injection, and to determine whether adjustments need to be made to the dose with subsequent administration.
†
Examples: aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, sodium colistimethate

Succinylcholine

The use of succinylcholine prior to Cisatracurium Besylate Injection administration may decrease the time to onset of maximum neuromuscular blockade but has no effect on the duration of neuromuscular blockade.

Inhalational Anesthetics

Administration of inhalational anesthetics with nitrous oxide/oxygen for greater than 30 minutes to achieve 1.25 Minimum Alveolar Concentration (MAC) may prolong the duration of action of initial and maintenance doses of Cisatracurium Besylate Injection. This may potentiate the neuromuscular blockade.

Antibiotics†
Local anesthetics
Magnesium salts
Procainamide
Lithium
Quinidine

May prolong the neuromuscular blockade action of Cisatracurium Besylate Injection

Phenytoin, Carbamazepine

May increase resistance to the neuromuscular blockade action of Cisatracurium Besylate Injection resulting in shorter durations of neuromuscular blockade and infusion rate requirements may be higher.

7.2 Drugs Without Clinically Significant Drug Interactions With Cisatracurium Besylate Injection

In clinical studies, propofol had no effect on the duration of action or dosing requirements for cisatracurium besylate. Cisatracurium besylate is not compatible with propofol for Y-site administration.
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