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Drug Interactions between Anectine Flo-Pack and Phospholine Iodide

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

succinylcholine echothiophate iodide ophthalmic

Applies to: Anectine Flo-Pack (succinylcholine) and Phospholine Iodide (echothiophate iodide ophthalmic)

GENERALLY AVOID: Echothiophate ophthalmic solution, a long-acting anticholinesterase inhibitor, prolongs the neuromuscular blocking effects of succinylcholine. The mechanism appears to be inhibition of cholinesterase-mediated succinylcholine metabolism. Prolonged apnea or death may occur. Plasma cholinesterase activity may be reduced in patients with genetic abnormalities of plasma cholinesterase (e.g., patients heterozygous or homozygous for atypical plasma cholinesterase gene), pregnancy, severe liver or kidney disease, malignant tumors, infections, burns, anemia, decompensated heart disease, peptic ulcer, or myxedema.

MANAGEMENT: This combination should be avoided and a neuromuscular blocker other than succinylcholine should be considered in patients receiving chronic echothiophate therapy. If succinylcholine must be used, patients should be closely monitored for prolonged neuromuscular blocking effects. Some authorities recommend that echothiophate ophthalmic drops should be discontinued several months prior to administration of succinylcholine and/or consideration should be given to using a reduced dose of succinylcholine.

References

  1. Mone JG, Mathie WE (1967) "Qualitative and quantitative defects of pseudocholinestease activity." Anaesthesia, 22, p. 55-68
  2. Cavallaro RJ, Krumperman LW, Kugler F (1968) "Effect of echothiophate therapy on the metabolism of succinylcholine in man." Anesth Analg, 47, p. 570-4
  3. Kinyon GE (1969) "Anticholinesterase eye drops--need for caution." N Engl J Med, 280, p. 53
  4. Lipson ML, Holmes JH, Ellis PP (1969) "Oral administration of pralidoxime chloride in echothiophate iodide therapy." Arch Ophthalmol, 82, p. 830-5
  5. Cohen PJ, Reynolds RC, Naidl J (1970) "A simple test for abnormal pseudocholinesterase." Anesthesiology, 32, p. 281-2
  6. Kothary SP, Tether JE, Flynn KB, Zsigmond EK (1977) "Plasmacholinesterase activity in relation to the safe use of succinylcholine in myasthenic patients on chronic anticholinesterase treatment." Clin Pharmacol Ther, 21, p. 108
  7. Eilderton TE, farmati O, Zsigmond EK (1968) "Reduction in plasma cholinesterase levels after prolonged administration of echothiophate iodide eyedrops." Can Anaesth Soc J, 15, p. 291-6
  8. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  9. Cerner Multum, Inc. "Australian Product Information."
View all 9 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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.

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