Mivacron Drug Interactions

The neuromuscular block produced by MIVACRON may be potentiated by the concomitant use of inhalational anaesthetics such as enflurane, isoflurane, sevoflurane and halothane.
MIVACRON has been safely administered following suxamethonium-facilitated tracheal intubation. Evidence of spontaneous recovery from suxamethonium should be observed prior to administration of MIVACRON.
In common with all non-depolarising neuromuscular blocking agents the magnitude and/or duration of a non-depolarising neuromuscular block may be increased and maintenance requirements may be reduced as a result of interaction with: antibiotics: including the aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin and clindamycin; anti-arrhythmic drugs: propranolol, calcium channel blockers, lidocaine, procainamide and quinidine; diuretics: furosemide and possibly thiazides, mannitol and acetazolamide; magnesium salts; ketamine; lithium salts; ganglion blocking drugs: trimetaphan, hexamethonium.
Drugs that may reduce plasma cholinesterase activity may also prolong the neuromuscular blocking action of MIVACRON. These include anti-mitotic drugs, monoamine oxidase inhibitors, ecothiopate iodide, pancuronium, organophosphates, anticholinesterases, certain hormones, bambuterol and selective serotonin uptake inhibitors.
Rarely, certain drugs may aggravate or unmask latent myasthenia gravis or actually induce a myasthenic syndrome; increased sensitivity to MIVACRON would be consequent on such a development. Such drugs include various antibiotics, beta-blockers (propranolol, oxprenolol), anti-arrhythmic drugs (procainamide, quinidine), anti-rheumatic drugs (chloroquine, D-pencillamine), trimetaphan, chlorpromazine, steroids, phenytoin and lithium.
The administration of combinations of non-depolarising neuromuscular blocking agents in conjunction with MIVACRON may produce a degree of neuromuscular blockade in excess of that which might be expected from an equipotent total dose of MIVACRON. Any synergistic effect may vary between different drug combinations.
A depolarising muscle relaxant such as suxamethonium chloride should not be administered to prolong the neuromuscular blocking effects of non-depolarising agents, as this may result in a prolonged and complex block which can be difficult to reverse with anti-cholinesterase drugs.