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      Drugs & Diseases

      vecuronium (Rx)

      Brand and Other Names:Norcuron
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      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      powder for injection

      • 10mg
      • 20mg

      General Anesthesia

      Adjunct to general anesthesia-induced muscle relaxation for endotracheal intubation, mechanical ventilation

      Dose should be calculated based on ideal body weight

      Injection

      • Load: 0.08-0.1 mg/kg IVP over 60 sec OR  
      • 0.04-0.06 mg/kg IVP if following succinylcholine, PLUS
      • Maintenance: 0.01-0.015 mg/kg IVP 20-45min post initial PRN

      Continuous Infusion

      • Load: 0.001 mg/kg/min IV starting 20 min post bolus recovery
      • Maintenance: 0.0008-0.0012 mg/kg/min

      Dosage Forms & Strengths

      powder for injection

      • 10mg
      • 20mg

      General Anesthesia

      Adjunct to general anesthesia-induce muscle relaxation for endotracheal intubation, mechanical ventilation

      1-10 years old

      • 0.1 mg/kg IVP; repeat q1hour PRN; OR  
      • Continuous Infusion: 0.05-0.07 mg/kg/hour IV

      Neonates; <28 days old (off-label)

      • Load: 0.1 mg/kg IV x1 dose
      • Maintenance: 0.03-0.15 mg/kg IV q1-2hours PRN

      7 weeks-1 year old (off-label)

      • Load: 0.08-0.1 mg/kg IV x1 dose
      • Maintenance: 0.05-0.1 mg/kg IV q1hour PRN
      Next:

      Interactions

      Interaction Checker

      and vecuronium

      No Results

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        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

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                 activity indicator 

                Contraindicated (1)

                • dantrolene

                  dantrolene, vecuronium. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. May potentiate vecuronium-induced neuromuscular block.

                Serious - Use Alternative (29)

                • amikacin

                  amikacin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • amphotericin B deoxycholate

                  amphotericin B deoxycholate increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • benzhydrocodone/acetaminophen

                  benzhydrocodone/acetaminophen, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • clindamycin

                  clindamycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • colistin

                  vecuronium 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • doxycycline

                  doxycycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • fentanyl

                  fentanyl, vecuronium. 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, vecuronium. 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, vecuronium. 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, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • hydrocodone

                  hydrocodone, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • minocycline

                  minocycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • neomycin PO

                  neomycin PO increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • omadacycline

                  omadacycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • oxytetracycline

                  oxytetracycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • paromomycin

                  paromomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • polymyxin B

                  polymyxin B increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of resp. depression.

                • pramlintide

                  pramlintide, vecuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

                • quinine

                  quinine increases effects of vecuronium by pharmacodynamic synergism. Contraindicated. Risk of resp. depression.

                • sarecycline

                  sarecycline increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • streptomycin

                  streptomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • sufentanil SL

                  sufentanil SL, vecuronium. 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 vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

                • tobramycin

                  tobramycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of apnea.

                • valerian

                  valerian and vecuronium both increase sedation. Avoid or Use Alternate Drug.

                Monitor Closely (113)

                • abobotulinumtoxinA

                  vecuronium increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Neuromuscular blockers may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

                • aclidinium

                  aclidinium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • amitriptyline

                  vecuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • amoxapine

                  vecuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • anticholinergic/sedative combos

                  anticholinergic/sedative combos and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • aripiprazole

                  vecuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

                  aripiprazole increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • atracurium

                  atracurium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • atropine

                  atropine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • atropine IV/IM

                  atropine IV/IM and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • belladonna alkaloids

                  belladonna alkaloids and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • belladonna and opium

                  belladonna and opium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • benperidol

                  vecuronium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                  benperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • betamethasone

                  vecuronium, 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • buprenorphine, long-acting injection

                  vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cevimeline

                  cevimeline increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • chlorpromazine

                  vecuronium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  chlorpromazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • cisatracurium

                  cisatracurium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • clomipramine

                  vecuronium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • clozapine

                  vecuronium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

                  clozapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • corticotropin

                  vecuronium, corticotropin. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • cortisone

                  vecuronium, cortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • cyclizine

                  cyclizine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • cyclobenzaprine

                  cyclobenzaprine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • darifenacin

                  darifenacin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • deflazacort

                  vecuronium, deflazacort. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • desipramine

                  vecuronium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • dexamethasone

                  vecuronium, dexamethasone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • dicyclomine

                  dicyclomine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • diphenhydramine

                  diphenhydramine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • donepezil

                  donepezil increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • donepezil transdermal

                  donepezil transdermal and vecuronium both increase pharmacodynamic synergism. Use Caution/Monitor. Donepezil transdermal, a cholinesterase inhibitor, may potentiate the effects on muscle relacation during anesthesia.

                • dosulepin

                  vecuronium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • doxapram

                  doxapram decreases effects of vecuronium by pharmacodynamic antagonism. Use Caution/Monitor.

                • doxepin

                  vecuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • droperidol

                  vecuronium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                  droperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • echothiophate iodide

                  echothiophate iodide increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • fesoterodine

                  fesoterodine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • flavoxate

                  flavoxate and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • fludrocortisone

                  vecuronium, fludrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • fluphenazine

                  vecuronium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  fluphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • fosphenytoin

                  fosphenytoin decreases effects of vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • glycopyrrolate

                  glycopyrrolate and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • glycopyrrolate inhaled

                  glycopyrrolate inhaled and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • haloperidol

                  vecuronium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                  haloperidol increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • henbane

                  henbane and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • homatropine

                  homatropine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • huperzine A

                  huperzine A increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • hydrocortisone

                  vecuronium, hydrocortisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • hyoscyamine

                  hyoscyamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • hyoscyamine spray

                  hyoscyamine spray and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • iloperidone

                  vecuronium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                  iloperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • imipramine

                  vecuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • ipratropium

                  ipratropium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

                • lofepramine

                  vecuronium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • loxapine

                  vecuronium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

                  loxapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • loxapine inhaled

                  loxapine inhaled increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                  vecuronium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

                • magnesium sulfate

                  magnesium sulfate increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Interaction occurs with parenteral magnesium.

                • magnesium supplement

                  magnesium supplement, vecuronium. 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

                  vecuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • meclizine

                  meclizine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • methscopolamine

                  methscopolamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • methylprednisolone

                  vecuronium, 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • nortriptyline

                  vecuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • olanzapine

                  vecuronium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

                  olanzapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • oliceridine

                  oliceridine, vecuronium. 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 vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • orphenadrine

                  vecuronium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • oxybutynin

                  oxybutynin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • oxybutynin topical

                  oxybutynin topical and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • oxybutynin transdermal

                  oxybutynin transdermal and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • oxycodone

                  oxycodone increases effects of vecuronium 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

                  vecuronium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                  paliperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • pancuronium

                  pancuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • perphenazine

                  vecuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  perphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • phenytoin

                  phenytoin decreases effects of vecuronium 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 vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pilocarpine

                  pilocarpine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pimozide

                  vecuronium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

                  pimozide increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • piperacillin

                  piperacillin increases toxicity of vecuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Neuromuscular blockade may be prolonged.

                • pralidoxime

                  pralidoxime and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • prednisolone

                  vecuronium, prednisolone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • prednisone

                  vecuronium, prednisone. Other (see comment). Use Caution/Monitor. Comment: Coadministration of corticosteroids and neuromuscular blockers may increase risk of developing acute myopathy.

                • prochlorperazine

                  vecuronium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  prochlorperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • promethazine

                  vecuronium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  promethazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • propantheline

                  propantheline and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • protriptyline

                  vecuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • pyridostigmine

                  pyridostigmine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • quetiapine

                  vecuronium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

                  quetiapine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • rapacuronium

                  rapacuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • risperidone

                  vecuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                  risperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • rocuronium

                  rocuronium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • scopolamine

                  scopolamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • sevoflurane

                  sevoflurane increases levels of vecuronium by pharmacodynamic synergism. Use Caution/Monitor.

                • sodium sulfate/?magnesium sulfate/potassium chloride

                  sodium sulfate/?magnesium sulfate/potassium chloride increases effects of vecuronium 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 vecuronium by Other (see comment). Use Caution/Monitor. Comment: Magnesium may potentiate the effects of the neuromuscular blocking agents.

                • solifenacin

                  solifenacin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • succinylcholine

                  succinylcholine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • thioridazine

                  vecuronium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  thioridazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • thiothixene

                  vecuronium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                  thiothixene increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • tiotropium

                  tiotropium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • tobramycin inhaled

                  tobramycin inhaled increases effects of vecuronium by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Aminoglycosides may aggravate muscle weakness because of a curare-like effect.

                • tolterodine

                  tolterodine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • trazodone

                  vecuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • triamcinolone acetonide injectable suspension

                  vecuronium, 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

                  vecuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                  trifluoperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • trimipramine

                  vecuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • trospium chloride

                  trospium chloride and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • ziprasidone

                  vecuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

                  ziprasidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                • zotepine

                  vecuronium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                  vecuronium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

                Minor (37)

                • acetazolamide

                  acetazolamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • amlodipine

                  amlodipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • carbamazepine

                  carbamazepine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • clevidipine

                  clevidipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • clonazepam

                  clonazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • diazepam

                  diazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • diltiazem

                  diltiazem increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • dimenhydrinate

                  dimenhydrinate increases toxicity of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

                • donepezil

                  donepezil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • eslicarbazepine acetate

                  eslicarbazepine acetate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • ethosuximide

                  ethosuximide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • felbamate

                  felbamate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • felodipine

                  felodipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • gabapentin

                  gabapentin decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • gabapentin enacarbil

                  gabapentin enacarbil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • galantamine

                  galantamine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • isradipine

                  isradipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • lacosamide

                  lacosamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • lamotrigine

                  lamotrigine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • levetiracetam

                  levetiracetam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • lithium

                  lithium increases effects of vecuronium by unknown mechanism. Minor/Significance Unknown.

                • lorazepam

                  lorazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • methsuximide

                  methsuximide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • nicardipine

                  nicardipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • nifedipine

                  nifedipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • nisoldipine

                  nisoldipine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • oxcarbazepine

                  oxcarbazepine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • phenobarbital

                  phenobarbital decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • primidone

                  primidone decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • quinidine

                  quinidine increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown.

                • rufinamide

                  rufinamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • thiamine

                  thiamine increases effects of vecuronium by unspecified interaction mechanism. Minor/Significance Unknown.

                • tiagabine

                  tiagabine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • topiramate

                  topiramate decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • valproic acid

                  valproic acid decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

                • verapamil

                  verapamil increases effects of vecuronium by pharmacodynamic synergism. Minor/Significance Unknown. Ca Channel Blockers interfere w/Ach release from prejunctional axon.

                • zonisamide

                  zonisamide decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

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                Adverse Effects

                Frequency Not Defined

                Skeletal muscle weakness or paralysis

                Respiratory insufficiency or apnea

                Hypersensitivity reactions associated with histamine release (e.g., bronchospasm, flushing, erythema, acute urticaria, hypotension, tachycardia)

                Itching

                Myositis ossificans (prolonged use)

                Acute quadriplegic myopathy syndrome (prolonged use)

                Less cardiovascular effects than pancuronium or atracurium

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                Warnings

                Black Box Warnings

                The drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards

                Contraindications

                Hypersensitivity

                Lack of ventilatory support

                Neuromuscular disease

                Cautions

                Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent

                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; neuromuscular cross-sensitivity with other nuromuscular blocking agents possible

                Some patients may experience prolonged recovery (paralysis) of neuromuscular function

                Adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience increased sensitivity with electrolyte disorders (hyperMg, hypoK, hypoCa)

                CAUTION: Hepatobiliary obstruction, renal dysfunction will significantly prolong duration of action

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Not known if excreted in breast milk; effect on nursing infant not known; used during pregnancy only when clearly needed

                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.

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                Pharmacology

                Mechanism of Action

                Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist

                Pharmacokinetics

                Half-life: 3.3-9 min (distribution phase); 31-80 min (terminal phase); increased in hepatobiliary disease

                Clearance: 2.9-6.4 mL/min/kg (normal renal function); 2.5-4.5 mL/min/kg (renal dysfunction); 0.97-2.7 mL/min/kg (hepatic dysfunction)

                Vd: 50-120 mL/kg (central compartment, Vc); 179-400 mL/kg (steady-state, Vss)

                Metabolism: Not been fully characterized; aqueous solution in vitro has shown spontaneous deacetylation at the 3a- &/or 17ß-positions to form hydroxy derivatives

                Onset: 3-5 min

                Duration: 20-35 min

                Protein Bound: 60-90%

                Excretion: 30% excreted unchanged in urine, 45% excreted unchanged in bile/feces

                Less histamine release than pancuroniun or atracurium (and less effect on HR & MAP)

                Little effect on intraocular/intracranial pressure

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                Administration

                IV Incompatibilities

                Y-site: ampho B chol SO4, diazepam, etomidate, furosemide, thiopental

                IV Compatibilities

                Solution: NS, D5W, D5/NS, LR

                Additive: ciprofloxacin

                Y-site: aminophylline, amiodarone, cefazolin, cefuroxime, cimetidine, clarithromycin, diltiazem, dobutamine, dopamine, epinephrine, esmolol, fenoldopam, fentanyl, fluconazole, gatifloxacin, gentamicin, heparin, Hextend, hydrocortisone, hydromorphone, isoproterenol, labetalol, linezolid, lorazepam, midazolam, milrinone, morphine, nicardipine, nitroglycerin, norepinephrine, propofol, ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin

                IV Preparation

                Rapid direct injection: dilute vial to max of 2 mg/mL

                Infusion: dilute vial to max of 1 mg/mL

                Solution:

                • Rapid direct injection: dilute vial to max of 2 mg/mL
                • Infusion: dilute vial to max of 1 mg/mL

                IV Administration

                Give either as a rapid direct injection or as an infusion

                Storage

                Store at room temp

                Do not mix with alkaline drugs

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                		10 mg vial
                vecuronium bromide intravenous
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                		20 mg vial
                vecuronium bromide intravenous
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                		20 mg vial
                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                		10 mg vial
                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                		20 mg vial
                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                vecuronium bromide intravenous
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                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                vecuronium bromide intravenous

                NO MONOGRAPH AVAILABLE AT THIS TIME

                USES: Consult your pharmacist.

                HOW TO USE: Consult your pharmacist.

                SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Consult your pharmacist.

                DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: No monograph available at this time.

                MISSED DOSE: Consult your pharmacist.

                STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Create Your List of Plans

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                View explanations for tiers and restrictions
                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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