The following drugs have been shown to influence the magnitude and/or duration of action of non-depolarizing neuromuscular blocking agents: Effect of other drugs on Esmeron: Increased effect: Halogenated volatile anesthetics potentiate the neuromuscular block of Esmeron. The effect only becomes apparent with maintenance dosing (see Dosage & Administration). Reversal of the block with anticholinesterase inhibitors could also be inhibited.
After intubation with suxamethonium (see Precautions).
Long-term concomitant use of corticosteroids and Esmeron in the ICU may result in prolonged duration of neuromuscular block or myopathy (see Precautions and Adverse Reactions).
Other drugs: Antibiotics: aminoglycoside, lincosamide and polypeptide antibiotics, acylamino-penicillin antibiotics.
Diuretics, quinidine and its isomer quinine, magnesium salts, calcium channel blocking agents, lithium salts, local anesthetics (lidocaine i.v, bupivacaine epidural) and acute administration of phenytoin or β-blocking agents.
Recurarization has been reported after post-operative administration of: aminoglycoside, lincosamide, polypeptide and acylamino-penicillin antibiotics, quinidine, quinine and magnesium salts (see Precautions).
Decreased effect: Prior chronic administration of phenytoin or carbamazepine.
Protease inhibitors (gabexate, ulinastatin).
Variable effect: Administration of other non-depolarizing neuromuscular blocking agents in combination with Esmeron may produce attenuation or potentiation of the neuromuscular block, depending on the order of administration and the neuromuscular blocking agent used.
Suxamethonium given after the administration of Esmeron may produce potentiation or attenuation of the neuromuscular blocking effect of Esmeron.
Effect of Esmeron on other drugs: Esmeron combined with lidocaine may result in a quicker onset of action of lidocaine.