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Pancuronium Ciclosporin

Ciclosporin can cause considerable prolongation of the neuromuscular paralysis induced by pancuronium (42) in one patient (and also in another given vecuronium). Reversal required both neostigmine and edrophonium. Subsequently, recurarization occurred (SEDA-14, 116). Contributing factors could have been the solvent Cremophor EL in the ciclosporin formulation (Sandimmun) and minor renal dysfunction. [Pg.2673]

There i limited evidence to surest that the neuromuscular blocking effects of atracurium, pancuronium and vecuronium may be increased in some patients taking ciclosporin. There is also some evidence of reduced neuromuscular blockade with aza-thioprine and antilymphocyde immunoglobulins, but other evidence suggests that there is no clinically relevant interaction with azathioprine. [Pg.124]

The ciclosporin interaction may be partly due to the vehicle used in intravenous preparations. One idea is that Cremophor, a surfactant which has been used as a solvent for the ciclosporin, may increase the effective concentration of pancuronium at the neuromuscular junction. Both compounds have been observed in animal studies to increase vecuronium blockade, and Cremophor has also been seen to decrease the onset time... [Pg.124]

Direct information seems to be limited to the reports cited, and the interactions are not established. Although retrospective data suggest that aza-thioprine and antilymphocyte immunoglobulins can cause a reduction in the effects of neuromuscular blockers, and in some cases the dosage may need to be increased two- to fourfold, the only prospective study found that the interaction with azathioprine was not clinically significant. The general importance of the ciclosporin interaction is also uncertain, but be alert for an increase in the effects of atracurium, pancuronium or vecuronium in any patient receiving ciclosporin. Not all patients appear to develop this interaction. More study is needed. [Pg.125]


See other pages where Pancuronium Ciclosporin is mentioned: [Pg.124]    [Pg.125]   
See also in sourсe #XX -- [ Pg.124 ]




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