Notrixum Drug Interactions

The neuromuscular block produced by Notrixum may be increased by the concomitant use of inhalation anesthetics, e.g. halothane, isoflurane and enflurane.
In common with all nondepolarising neuromuscular-blocking agents, the magnitude and/or duration of non depolarizing neuromuscular block may be increased as a result of interaction with: Antibiotic: Aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomysin and clindamycin.
Antiarrhythmic Drugs: Propanolol, calcium-channel blockers, lignocaine, procainamide and quinidine.
Diuretic: Furosemide and possibly mannitol, thiazide diuretics and acetazolamide.
Magnesium sulphate; fetamine; lithium salts.
Ganglion-blocking agents: Trimetaphan, hexamethonium.
Rarely, certain drugs may aggravate or unmask latent myasthenia gravis or actually induce a myasthenic syndrome; increased sensitivity to Notrixum would be consequent on such a development. Such drugs include various antibiotics, β-blockers (propanolol, oxprenolol), antiarrhytmic drugs (procainamide, quinidine), antirheumatic drugs (chloroquine, D – penicillamine), trimetaphan, chlorpromazine, steroids, phenytoin and lithium. The onset of nondepolarizing neuromuscular block is likely to be lengthened and the duration of block shortened in patients receiving chronic anticonvulsant therapy. The administration of combinations nondepolarising neuromuscular blocking agents in excess of that which might be expected were an equipotent total dose of Notrixum was administered. Any synergistic effect may vary between different drug combinations. A depolarizing muscle relaxant, e.g suxamethonium chloride should not be administered to prolong the neuromuscular blocking effects of nondepolarizing agents, e.g. Atracurium, as this may result in a prolonged and complex block which can be difficult to reverse with anticholinesterase drugs.