Skip to main content

Drug Interaction Report

1 drug interaction and 16 additional warnings found for the following 2 drugs:

Filter by interaction and/or warning

Drug interactions

Moderate drug interactions

Moderate:

succinylcholine chlorotrianisene

Applies to: Anectine Flo-Pack (succinylcholine), chlorotrianisene

Chlorotrianisene may increase or prolong the neuromuscular blocking effect of succinylcholine.

Let your doctor know prior to your procedure if you have been treated regularly with chlorotrianisene. You may need a dose adjustment or closer monitoring during and after your procedure to safely use both medications.

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

Minor food/lifestyle interactions

Minor:

Food/Lifestyle chlorotrianisene

Applies to: chlorotrianisene

Coadministration with grapefruit juice may increase the bioavailability of oral estrogens. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits. In a small, randomized, crossover study, the administration of ethinyl estradiol with grapefruit juice (compared to herbal tea) increased peak plasma drug concentration (Cmax) by 37% and area under the concentration-time curve (AUC) by 28%. Based on these findings, grapefruit juice is unlikely to affect the overall safety profile of ethinyl estradiol. However, as with other drug interactions involving grapefruit juice, the pharmacokinetic alterations are subject to a high degree of interpatient variability. Also, the effect on other estrogens has not been studied.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Disease interactions

15 potential interactionsApplies to: 15 conditions, including Allergies, Asthma, Myasthenia Gravis, Hyperkalemia, and Cardiovascular Conditions and Disorders.

Allergies

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack 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:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack 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:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Burns, External.

The use of succinylcholine is contraindicated in patients after the acute phase of injury following major burns. These patients are more likely to develop significant hyperkalemia which may lead to cardiac arrest. The risk of hyperkalemia typically peaks at about 7 to 10 days after injury.

Cardiovascular Conditions and Disorders

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack 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.

Cerebral Vascular Disorder

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Cerebral Vascular Disorder.

The use of succinylcholine is contraindicated in patients with upper motor neuron injury that can be a sequelae of cerebral vasculopathy. The risk of hyperkalemia is increased in these patients.

Glaucoma/Intraocular Hypertension

Moderate:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

The use of succinylcholine has been associated with an increase in intraocular pressure. Therapy with succinylcholine should be administered cautiously in patients with narrow-angle glaucoma.

Heart Block

Moderate:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a moderate potential interaction with Heart Block.

The use of succinylcholine may exacerbate bradycardia via vagal stimulation leading to asystole, especially after a second dose. Therapy with succinylcholine should be administered cautiously in patients with bradycardia.

Hemorrhagic Stroke

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Hemorrhagic Stroke.

The use of succinylcholine is contraindicated in patients after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury. has been associated with an elevation in potassium levels due to rapid release of potassium from intracellular sites. Therapy with succinylcholine should be administered cautiously in patients with hyperkalemic states such as extensive soft-tissue trauma, burns, chronic abdominal infections, and subarachnoid hemorrhage.

History (Familial) - Musculoskeletal Disorder

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with History (Familial) - Musculoskeletal Disorder.

The use of succinylcholine is contraindicated in patients with a personal or family history of skeletal muscle myopathies. Acute rhabdomyolysis with hyperkalemia followed by ventricular arrhythmias, cardiac arrest, and death have been reported following the administration of succinylcholine in apparently healthy children who were later found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy. Immediate treatment of hyperkalemia should be instituted whenever a healthy appearing infant or child develops cardiac arrest with no obvious cause soon after administration of succinylcholine.

History - Musculoskeletal Disorder

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with History - Musculoskeletal Disorder.

The use of succinylcholine is contraindicated in patients with a personal or family history of skeletal muscle myopathies. Acute rhabdomyolysis with hyperkalemia followed by ventricular arrhythmias, cardiac arrest, and death have been reported following the administration of succinylcholine in apparently healthy children who were later found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy. Immediate treatment of hyperkalemia should be instituted whenever a healthy appearing infant or child develops cardiac arrest with no obvious cause soon after administration of succinylcholine.

Hyperkalemia

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Hyperkalemia.

The use of succinylcholine is contraindicated in patients after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury. has been associated with an elevation in potassium levels due to rapid release of potassium from intracellular sites. Therapy with succinylcholine should be administered cautiously in patients with hyperkalemic states such as extensive soft-tissue trauma, burns, chronic abdominal infections, and subarachnoid hemorrhage.

Malignant Hyperthermia

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Malignant Hyperthermia.

The use of succinylcholine is contraindicated in patients with a personal or family history of malignant hyperthermia. Succinylcholine administration has been associated with acute onset of malignant hyperthermia, especially during the concomitant use of volatile anesthetics. If malignant hyperthermia occurs, anesthesia should be discontinued and supportive measures rendered promptly, including rapid cooling, inhalation of 100% oxygen, control of acidosis, support of circulation, and assurance of adequate urinary output. In addition, intravenous dantrolene sodium is recommended.

Myasthenia Gravis

Moderate:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a moderate potential interaction with Myasthenia Gravis.

Depolarizing agents, including succinylcholine, should be used with caution in patients with known neuromuscular junction disease. The succinylcholine-induced neuromuscular blockade may be prolonged in patients with myasthenia gravis (MG). Care should be exercised when using this agent in patients with existing, previously diagnosed MG.

Myopathy

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack has a major potential interaction with Myopathy.

The use of succinylcholine is contraindicated in patients with a personal or family history of skeletal muscle myopathies. Acute rhabdomyolysis with hyperkalemia followed by ventricular arrhythmias, cardiac arrest, and death have been reported following the administration of succinylcholine in apparently healthy children who were later found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne muscular dystrophy. Immediate treatment of hyperkalemia should be instituted whenever a healthy appearing infant or child develops cardiac arrest with no obvious cause soon after administration of succinylcholine.

Pulmonary Impairment

Major:

Anectine Flo-Pack

The succinylcholine in Anectine Flo-Pack 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.

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.

See also:

Further information

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