Can you take Mivacurium with Myrac?
1 drug interaction and 16 additional warnings found for the following 2 drugs:
- mivacurium
- Myrac (minocycline)
Drug interactions
Moderate drug interactions
Moderate:
minocycline mivacurium
Applies to: Myrac (minocycline) and mivacurium
Minocycline may increase the effects of mivacurium, which may result in a higher risk of respiratory depression and muscle weakness. Talk to your doctor if you have any concerns. You should be closely monitored by the doctor during the procedure, and the dosages adjusted as necessary. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
minocycline multivitamins with minerals
Applies to: Myrac (minocycline)
In general, multivitamins with minerals and minocycline should not be taken orally at the same time. Products that contain aluminum, calcium, iron, magnesium, zinc and/or other minerals may interfere with the absorption of minocycline into the bloodstream and reduce its effectiveness in treating your infection. If possible, it may be best to avoid taking multivitamins with minerals while you are being treated with minocycline. Otherwise, you should separate their dosing times by as much as possible, usually at least 2 to 4 hours. Talk to your healthcare provider if you are unsure whether your medications contain something that could potentially interact or if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
15 potential interactions Applies to: 13 conditions, including Allergies, Weight Loss, Asthma, Myasthenia Gravis, and Liver Disease.
Allergies
Major:
mivacurium
Mivacurium has a major potential interaction with Allergies.
Some neuromuscular blocking agents stimulate the release of histamine, which can cause wheezing, bronchospasm, increased bronchial secretions, hypotension, tachycardia, and circulatory collapse. Hypotension may also occur due to ganglionic blockade or as a complication of positive pressure respiration. Tubocurarine appears to be the most potent inducer of histamine, followed by metocurine (no longer commercially available in the U.S.) and succinylcholine. Other agents with varying but lesser degrees of histamine-releasing properties include atracurium, mivacurium, and pancuronium (at excessive dosages). Therapy with these neuromuscular blocking agents should be administered cautiously in patients with clinically significant cardiovascular disease and/or a history of asthma or severe allergic reactions. Certain agents may prolong the QTc interval, especially during general anesthesia in pediatric patients. The initial dosage and rate of administration may need to be reduced, and hemodynamic and respiratory status carefully monitored. Neuromuscular blocking agents that appear to have little or no histamine-inducing effects include cisatracurium, doxacurium, pipecuronium, rocuronium, and vecuronium.
Asthma
Major:
mivacurium
Mivacurium has a major potential interaction with Asthma.
Some neuromuscular blocking agents stimulate the release of histamine, which can cause wheezing, bronchospasm, increased bronchial secretions, hypotension, tachycardia, and circulatory collapse. Hypotension may also occur due to ganglionic blockade or as a complication of positive pressure respiration. Tubocurarine appears to be the most potent inducer of histamine, followed by metocurine (no longer commercially available in the U.S.) and succinylcholine. Other agents with varying but lesser degrees of histamine-releasing properties include atracurium, mivacurium, and pancuronium (at excessive dosages). Therapy with these neuromuscular blocking agents should be administered cautiously in patients with clinically significant cardiovascular disease and/or a history of asthma or severe allergic reactions. Certain agents may prolong the QTc interval, especially during general anesthesia in pediatric patients. The initial dosage and rate of administration may need to be reduced, and hemodynamic and respiratory status carefully monitored. Neuromuscular blocking agents that appear to have little or no histamine-inducing effects include cisatracurium, doxacurium, pipecuronium, rocuronium, and vecuronium.
Burns, External
Major:
mivacurium
Mivacurium has a major potential interaction with 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.
Cardiovascular Conditions and Disorders
Major:
mivacurium
Mivacurium has a major potential interaction with Cardiovascular Conditions and Disorders.
Some neuromuscular blocking agents stimulate the release of histamine, which can cause wheezing, bronchospasm, increased bronchial secretions, hypotension, tachycardia, and circulatory collapse. Hypotension may also occur due to ganglionic blockade or as a complication of positive pressure respiration. Tubocurarine appears to be the most potent inducer of histamine, followed by metocurine (no longer commercially available in the U.S.) and succinylcholine. Other agents with varying but lesser degrees of histamine-releasing properties include atracurium, mivacurium, and pancuronium (at excessive dosages). Therapy with these neuromuscular blocking agents should be administered cautiously in patients with clinically significant cardiovascular disease and/or a history of asthma or severe allergic reactions. Certain agents may prolong the QTc interval, especially during general anesthesia in pediatric patients. The initial dosage and rate of administration may need to be reduced, and hemodynamic and respiratory status carefully monitored. Neuromuscular blocking agents that appear to have little or no histamine-inducing effects include cisatracurium, doxacurium, pipecuronium, rocuronium, and vecuronium.
Esophageal Obstruction
Moderate:
Myrac
The minocycline in Myrac has a moderate potential interaction with Esophageal Obstruction.
The use of oral tetracycline capsules and tablets has been associated with esophageal irritation and ulceration in patients who ingested the drug without sufficient fluid shortly before bedtime. Therapy with solid formulations of tetracyclines should preferably be avoided in patients with esophageal obstruction, compression or dyskinesia. If the drugs are used, patients should be advised not to take the medication just before retiring and to drink fluids liberally.
Liver Disease
Major:
mivacurium
Mivacurium has a major potential interaction with Liver Disease.
Neuromuscular blocking agents undergo metabolism by the liver. Elimination and effects may be prolonged in patients with liver disease. Therapy with neuromuscular blocking agents should be administered cautiously in patients with liver disease.
Moderate:
Myrac
The minocycline in Myrac has a moderate potential interaction with Liver Disease.
The use of tetracyclines has rarely been associated with hepatotoxicity. Histologic fatty changes of the liver, elevated liver enzymes, and jaundice have been reported, primarily in patients treated with large doses of intravenous tetracycline hydrochloride (no longer available in the U.S.) but also in patients receiving high oral doses of these drugs. Therapy with tetracyclines should be administered cautiously in patients with preexisting liver disease or biliary obstruction. Reduced dosages may be appropriate, particularly with minocycline and doxycycline, since the former is metabolized by the liver and the latter undergoes enterohepatic recycling. Liver function tests are recommended prior to and during therapy, and the concomitant use of other potentially hepatotoxic drugs should be avoided.
Myasthenia Gravis
Major:
mivacurium
Mivacurium has a major potential interaction with Myasthenia Gravis.
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.
Noninfectious Colitis
Major:
Myrac
The minocycline in Myrac has a major potential interaction with Noninfectious Colitis.
Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.
Paralytic Disorder
Major:
mivacurium
Mivacurium has a major potential interaction with 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.
Prematurity/Underweight in Infancy
Major:
mivacurium
Mivacurium has a major potential interaction with 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.
Pulmonary Impairment
Major:
mivacurium
Mivacurium has a major potential interaction with 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.
Renal Dysfunction
Moderate:
mivacurium
Mivacurium has a moderate potential interaction with Renal Dysfunction.
Many of the non-depolarizing (competitive) neuromuscular blocking agents undergo significant elimination by the kidney. Their effects may, therefore, be prolonged in patients with renal dysfunction. Therapy with these neuromuscular blocking agents should be administered cautiously and initiated at reduced dosages in renally compromised patients, depending on the level of insufficiency. If possible, alternative agents should be considered. Atracurium, rocuronium and vecuronium do not depend on kidney function for clearance and are often the non-depolarizing muscle relaxants of choice in renal failure.
Moderate:
Myrac
The minocycline in Myrac has a moderate potential interaction with Renal Dysfunction.
Tetracyclines (except doxycycline) are eliminated by the kidney to various extent. Patients with renal impairment may be at greater risk for tetracycline-associated hepatic and/or renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. Therapy with tetracyclines should be administered cautiously at reduced dosages in patients with renal impairment. Clinical monitoring of renal and liver function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.
Weight Loss
Moderate:
mivacurium
Mivacurium has a moderate potential interaction with Weight Loss.
A few of the neuromuscular blocking agents, including doxacurium, mivacurium and pipecuronium, may have prolonged and/or enhanced effects in obese patients (i.e. weight >= 30% over ideal body weight for height). Dosing of these agents should be based on ideal body weight in obese patients.
More resources
mivacurium
A total of 180 drugs are known to interact with mivacurium.
- Mivacurium is in the drug class neuromuscular blocking agents.
Myrac
A total of 243 drugs are known to interact with Myrac.
- Myrac is in the drug class tetracyclines.
- Myrac is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.