Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 1mg/mL
- 2mg/mL
General Anesthesia Adjunct/Cesarean Section
Maintenance: 0.015-0.1 mg/kg IV q30-60min OR
Continuous infusion: 0.1 mg/kg/hr IV
Dose should be calculated based on ideal body weight
Monitoring of muscle twitch response to a peripheral nerve stimulator is advised
Endotracheal Intubation
Usually effective with in 2-3 minutes
Renal Impairment
CrCl >50 mL/min: Dose adjustment not necessary
CrCl 10-50 mL/min: Administer 50% normal dose
CrCl <10 mL/min: Do not use
Hepatic Impairment
Use caution
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (29)
- amikacin
amikacin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- amphotericin B deoxycholate
amphotericin B deoxycholate increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, pancuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- capreomycin
capreomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- clindamycin
clindamycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- colistin
pancuronium increases effects of colistin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potentiation of neuromuscular blockade; risk of respiratory arrest.
- demeclocycline
demeclocycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- doxycycline
doxycycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- fentanyl
fentanyl, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl intranasal
fentanyl intranasal, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transdermal
fentanyl transdermal, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transmucosal
fentanyl transmucosal, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- gentamicin
gentamicin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- hydrocodone
hydrocodone, pancuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- lincomycin
lincomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- minocycline
minocycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- neomycin PO
neomycin PO increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- omadacycline
omadacycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- oxytetracycline
oxytetracycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- paromomycin
paromomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- polymyxin B
polymyxin B increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.
- pramlintide
pramlintide, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- quinine
quinine increases effects of pancuronium by pharmacodynamic synergism. Contraindicated. Risk of resp. depression.
- sarecycline
sarecycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- streptomycin
streptomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- sufentanil SL
sufentanil SL, pancuronium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tetracycline
tetracycline increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.
- tobramycin
tobramycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.
- valerian
valerian and pancuronium both increase sedation. Avoid or Use Alternate Drug.
Monitor Closely (112)
- abobotulinumtoxinA
pancuronium increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- aclidinium
pancuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amitriptyline
pancuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
pancuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- aripiprazole
pancuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atracurium
atracurium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
pancuronium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - betamethasone
pancuronium, betamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- bethanechol
bethanechol increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- buprenorphine, long-acting injection
pancuronium increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- carbachol
carbachol increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cevimeline
cevimeline increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
pancuronium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cisatracurium
cisatracurium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clomipramine
pancuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clozapine
pancuronium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - corticotropin
pancuronium, corticotropin. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cortisone
pancuronium, cortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- cyclizine
cyclizine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- darifenacin
darifenacin and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- deflazacort
pancuronium, deflazacort. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- desipramine
pancuronium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dexamethasone
pancuronium, dexamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- dicyclomine
dicyclomine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- donepezil
donepezil increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal and pancuronium both increase pharmacodynamic synergism. Use Caution/Monitor. Donepezil transdermal, a cholinesterase inhibitor, may potentiate the effects on muscle relacation during anesthesia.
- dosulepin
pancuronium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxapram
doxapram decreases effects of pancuronium by pharmacodynamic antagonism. Use Caution/Monitor.
- doxepin
pancuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- droperidol
pancuronium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
fesoterodine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
flavoxate and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fludrocortisone
pancuronium, fludrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- fluphenazine
pancuronium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - fosphenytoin
fosphenytoin decreases effects of pancuronium by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Monitor closely for more rapid recovery from neuromuscular blockade than expected; infusion rate requirements may be higher.
- galantamine
galantamine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
pancuronium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
henbane and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
pancuronium, hydrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- hyoscyamine
hyoscyamine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
pancuronium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
pancuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ipratropium
ipratropium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- lofepramine
pancuronium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- loxapine
pancuronium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
pancuronium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - magnesium sulfate
magnesium sulfate increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Interaction occurs with parenteral magnesium.
- magnesium supplement
magnesium supplement, pancuronium. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Each enhance the neuromuscular blocking effect of the other; may have negative respiratory effects.
- maprotiline
pancuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclizine
meclizine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methscopolamine
methscopolamine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylprednisolone
pancuronium, methylprednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- neostigmine
neostigmine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
pancuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- olanzapine
pancuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oliceridine
oliceridine, pancuronium. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- onabotulinumtoxinA
onabotulinumtoxinA and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- orphenadrine
pancuronium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin
oxybutynin and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone increases effects of pancuronium by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Oxycodone may enhance the neuromuscular blocking action of true skeletal muscle relaxants and produce an increased degree of respiratory depression.
- paliperidone
pancuronium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - perphenazine
pancuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - phenytoin
phenytoin decreases effects of pancuronium by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Monitor closely for more rapid recovery from neuromuscular blockade than expected; infusion rate requirements may be higher.
- physostigmine
physostigmine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
pancuronium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pralidoxime
pancuronium and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.
- prednisolone
pancuronium, prednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prednisone
pancuronium, prednisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- prochlorperazine
pancuronium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
pancuronium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
pancuronium and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- protriptyline
pancuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
pancuronium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rapacuronium
pancuronium and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- risperidone
pancuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rocuronium
pancuronium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scopolamine
pancuronium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- sevoflurane
sevoflurane increases levels of pancuronium by pharmacodynamic synergism. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of pancuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of pancuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.
- solifenacin
pancuronium and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- succinylcholine
succinylcholine increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
pancuronium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
pancuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
pancuronium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tobramycin inhaled
tobramycin inhaled increases effects of pancuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Aminoglycosides may aggravate muscle weakness because of a curare-like effect.
- tolterodine
pancuronium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trazodone
pancuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
- triamcinolone acetonide injectable suspension
pancuronium, triamcinolone acetonide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.
- trifluoperazine
pancuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trimipramine
pancuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trospium chloride
pancuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
pancuronium, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - vecuronium
pancuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ziprasidone
pancuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
pancuronium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (37)
- acetazolamide
acetazolamide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- amlodipine
amlodipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- carbamazepine
carbamazepine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- clevidipine
clevidipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- clonazepam
clonazepam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- diazepam
diazepam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- diltiazem
diltiazem increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- dimenhydrinate
dimenhydrinate increases toxicity of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethosuximide
ethosuximide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felbamate
felbamate decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- felodipine
felodipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- gabapentin
gabapentin decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- gabapentin enacarbil
gabapentin enacarbil decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- isradipine
isradipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- lacosamide
lacosamide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lamotrigine
lamotrigine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- levetiracetam
levetiracetam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lithium
lithium increases effects of pancuronium by unknown mechanism. Minor/Significance Unknown.
- lorazepam
lorazepam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- methsuximide
methsuximide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- nicardipine
nicardipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nifedipine
nifedipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- nisoldipine
nisoldipine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- oxcarbazepine
oxcarbazepine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- phenobarbital
phenobarbital decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- primidone
primidone decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown.
- rufinamide
rufinamide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- thiamine
thiamine increases effects of pancuronium by unspecified interaction mechanism. Minor/Significance Unknown.
- tiagabine
tiagabine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- topiramate
topiramate decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- valproic acid
valproic acid decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- verapamil
verapamil increases effects of pancuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.
- zonisamide
zonisamide decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Slight elevation in pulse rate
Elevations in blood pressure
Excessive salivation
Excessive sweating (in children)
Transient rashes
Wheezing
Dose-related tachycardia
Histamine release (bronchospasm/hypotension)
Warnings
Black Box Warnings
The drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards
Contraindications
Lack of ventilatory support, neuromuscular disease
Hypersensitive to drug &/or bromides
Cautions
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
Use caution in patients with poor renal perfusion or severe renal disease, preexisting tachycardia
Adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)
Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk; effect on nursing infant not known
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist
Half-Life:
2 hr (terminal phase)
Renal dysfunction may incr half-life 50%
Pharmacokinetics
Onset: 1-2 min
Half-life: 2 hr (terminal phase); half-life may increase 50% in renal insuficiency
Duration: 60-100 min (dose dependent)
Protein Bound: 87% (range: 77-91%)
Metabolism: primarily none, some hepatic transformation to weakly active metabolite
Excretion: Unchanged in urine
Little effect on intraocular/intracranial pressure
Very rarely causes release of histamine (and hypotension, bronchospasm, flushing); more commonly causes dose-related tachycardia by blocking cardiac ACh receptors
Administration
IV Compatibilities
Additive: ciprofloxacin, verapamil
Syringe: caffeine, heparin
Y-site: aminophylline, cefazolin, cefuroxime, cimetidine, dobutamine, dopamine, epinephrine, esmolol, etomidate, fenoldopam, fentanyl, fluconazole, gentamicin, heparin, Hextend, hydrocortisone, isoproterenol, levofloxacin, lorazepam, midazolam, milrinone, morphine, nitroglycerin, propofol (1 mg/mL), ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin
IV Incompatibilities
Y-site: diazepam, thiopental
IV Preparation
Solution: add to an empty Viaflex bag & infuse undiluted (2 mg/mL); however, if necessary, may be diluted in D5W, NS, or LR
Continuous infusions may be given by using undiluted drug
IV Administration
Use controlled microinfusion device
Storage
Store at 2-8 C; stable at RT x 6mth
Images
Formulary
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