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abobotulinumtoxinA intramuscular

Neuromuscular Blocking Agents/Polypeptide Antibiotics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, the effect of your neuromuscular blocking medicine may increase.

What might happen:

The effects of the neuromuscular blocker may increase.

What you should do about this interaction:

Neuromuscular blockers are only used during surgical procedures or in a hospital. If you are to have either inpatient or outpatient surgery, or are to be admitted to the hospital, make sure that all the healthcare professionals are aware of all the different medicines that you are taking. This includes prescription medicines, herbal drugs, and nutraceuticals.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.


1.Sobek V. Arrest of respiration induced by polypeptide antibiotics. Arzneimittelforschung 1982;32(3):235-7.
2.Durant NN, Lambert JJ. The action of polymyxin B at the frog neuromuscular junction. Br J Pharmacol 1981 Jan;72(1):41-7.
3.Fogdall RP, Miller RD. Prolongation of a pancuronium-induced neuronmuscular blockade by polymyxin B. Anesthesiology 1974 Jan; 40(1):84-7.
4.Fiekers JF. Neuromuscular block produced by polymyxin B: interaction with end-plate channels. Eur J Pharmacol 1981 Mar 5;70(1):77-81.
5.Timmerman JC, Long JP, Pittinger CB. Neuromuscular blocking properties of various antibiotic agents. Tox Appl Pharmacol 1959;1:299-304.
6.Zauder HL, Barton N, Bennett EJ, Lore J. Colistimethate as a cause of postoperative apnoea. Can Anaesth Soc J 1966 Nov;13(6):607-10.
7.Lindesmith LA, Baines RD Jr, Bigelow DB, Petty TL. Reversible respiratory paralysis associated with polymyxin therapy. Ann Intern Med 1968 Feb; 68(2):318-27.
8.Gebbie D. Colistimethate and curare: a case report. Anesth Analg 1971 Jan-Feb;50(1):109-11.
9.Van Nyhuis LS, Miller RD, Fogdall RP. The interaction between d-tubocurarine, pancuronium, polymyxin B, and neostigmine on neuromuscular function. Anesth Analg 1976 Mar-Apr;55(2):224-8.
10.Burkett L, Bikhazi GB, Thomas KC Jr, Rosenthal DA, Wirta MG, Foldes FF. Mutual potentiation of the neuromuscular effects of antibiotics and relaxants. Anesth Analg 1979 Mar-Apr;58(2):107-15.
11.Chapple DJ, Clark JS, Hughes R. Interaction between atracurium and drugs used in anaesthesia. Br J Anaesth 1983;55 Suppl 1:17S-22S.
12.Kronenfeld MA, Thomas SJ, Turndorf H. Recurrence of neuromuscular blockade after reversal of vecuronium in a patient receiving polymyxin/amikacin sternal irrigation. Anesthesiology 1986 Jul; 65(1):93-4.
13.Huang KC, Heise A, Shrader AK, Tsueda K. Vancomycin enhances the neuromuscular blockade of vecuronium. Anesth Analg 1990 Aug;71(2):194-6.

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