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Nimbex (cisatracurium) Disease Interactions

There are 5 disease interactions with Nimbex (cisatracurium):

Major

MDVs (applies to Nimbex) prematurity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Prematurity/Underweight in Infancy

Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

References

  1. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
  2. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  5. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  6. "Product Information. Mesnex (mesna)." Bristol-Myers Squibb, Princeton, NJ.
View all 6 references
Major

Neuromuscular blocking agents (applies to Nimbex) burns

Major Potential Hazard, High plausibility. Applicable conditions: Burns - External

Patients with burns may develop resistance to non-depolarizing neuromuscular blocking agents. These patients may experience a shorter duration of action and/or require higher dosages of the drugs. The extent of altered response depends on the duration since and the size of the burn.

References

  1. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
Major

Neuromuscular blocking agents (applies to Nimbex) myasthenia gravis

Major Potential Hazard, High plausibility.

The use of neuromuscular blocking agents may cause prolonged respiratory paralysis. Therapy with neuromuscular blocking agents should be administered cautiously in patients with myasthenia gravis. Use of a peripheral nerve stimulator may be helpful in evaluating the level of neuromuscular blockade.

References

  1. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Metubine Iodide (metocurine)." Dista Products Company, Indianapolis, IN.
View all 4 references
Major

Neuromuscular blocking agents (applies to Nimbex) paresis

Major Potential Hazard, High plausibility. Applicable conditions: Paralytic Disorder

Patients with hemiparesis or paraparesis may require higher dosages of non-depolarizing neuromuscular blocking agents in the affected limbs. Neuromuscular monitoring should be performed on a non-paretic limb to avoid inaccurate dosing.

References

  1. "Product Information. Norcuron (vecuronium)." Organon, West Orange, NJ.
  2. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Metubine Iodide (metocurine)." Dista Products Company, Indianapolis, IN.
  4. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  5. "Product Information. Zemuron (rocuronium)." Organon, West Orange, NJ.
  6. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
View all 6 references
Major

Neuromuscular blocking agents (applies to Nimbex) pulmonary impair

Major Potential Hazard, High plausibility. Applicable conditions: Pulmonary Impairment

Neuromuscular blocking agents can cause respiratory depression and paralysis. Therapy with neuromuscular blocking agents should be administered cautiously in patients with pulmonary impairment. Treatment of respiratory paralysis consists of positive-pressure artificial respiration with oxygen and maintenance of a patent airway until the recovery of normal respiration is assured.

References

  1. "Product Information. Norcuron (vecuronium)." Organon, West Orange, NJ.
  2. "Product Information. Metubine Iodide (metocurine)." Dista Products Company, Indianapolis, IN.
  3. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  5. "Product Information. Anectine (succinylcholine)." Glaxo Wellcome, Research Triangle Park, NC.
  6. "Product Information. Zemuron (rocuronium)." Organon, West Orange, NJ.
  7. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
View all 7 references

Nimbex (cisatracurium) drug interactions

There are 153 drug interactions with Nimbex (cisatracurium)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.