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Drug Interactions between Neosar and succinylcholine

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

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Interactions between your drugs

Moderate

cycloPHOSphamide succinylcholine

Applies to: Neosar (cyclophosphamide) and succinylcholine

GENERALLY AVOID: Cyclophosphamide may increase the effects of succinylcholine. The mechanism is irreversible inhibition of plasma cholinesterase resulting in decreased metabolism of some neuromuscular blockers. Apnea has been associated with this drug combination. Reductions in cholinesterase levels of 35% to 70% have been reported. This effect may last for up to several weeks after administration of cyclophosphamide.

MANAGEMENT: Succinylcholine should probably be avoided in patients with low cholinesterase levels. Other patients should be closely monitored for excessive and prolonged neuromuscular blockade and ventilatory support should be available.

References

  1. Dillman JB (1987) "Safe use of succinylcholine during repeated anesthetics in a patient treated with cyclophosphamide." Anesth Analg, 66, p. 351-3
  2. Zsigmond EK, Robins G (1972) "The effect of a series of anti-cancer drugs on plasma cholinesterase activity." Can Anaesth Soc J, 19, p. 75-82
  3. Walker IR, Zapf PW, Mackay IR (1972) "Cyclophosphamide, cholinesterase and anaesthesia." Aust N Z J Med, 2, p. 247-51
  4. (2001) "Product Information. Anectine (succinylcholine)." Glaxo Wellcome
View all 4 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.

Further information

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

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