Rocuronium Kabi Drug Interactions

The following medicinal products have been shown to influence the magnitude and/or duration of the effect of non-depolarizing neuromuscular blocking agents: Increased effect: Halogenated volatile anaesthetics.
High doses of: thiopental, methohexital, ketamine, fentanyl, gammahydroxybutyrate, etomidate and propofol.
Other non-depolarizing neuromuscular blocking agents.
Prior administration of suxamethonium (see Precautions).
Long term concomitant use of corticosteroids and Rocuronium in the ICU may result in prolonged duration of neuromuscular block or myopathy (see Precautions and Adverse Reactions).
Other medicinal products: Antibiotics: aminoglycosides, lincosamides (e.g. lincomycin and clindamycin), polypeptide antibiotics, acylamino-penicillin antibiotics, tetracyclines, high doses of metronidazole.
Diuretics, thiamine, MAO inhibiting agents, quinidine and its isomer quinine, protamine, adrenergic blocking agents, magnesium salts, calcium channel blocking agents and lithium salts and local anaesthetics (lidocaine i.v., bupivacaine epidural).
Decreased effect: Neostigmine, edrophonium, pyridostigmine, aminopyridine derivatives.
Prior chronic administration of corticosteroids, phenytoin or carbamazepine.
Noradrenaline, azathioprine (only transient and limited effect), theophylline, calcium chloride, potassium chloride.
Protease inhibitors.
Variable effect: Administration of other non-depolarizing neuromuscular blocking agents in combination with rocuronium bromide may produce attenuation or potentiation of the neuromuscular block, depending on the order of administration and the neuromuscular blocking agent used.
Suxamethonium given after the administration of rocuronium bromide may produce potentiation or attenuation of the neuromuscular blocking effect of rocuronium bromide.
Effect of rocuronium on other drugs: Combined use with lidocaine could result in a more instant effect of lidocaine.
Recurarization has been reported after post-operative administration of: aminoglycoside, lincosamide, polypeptide and acylamino-penicillin antibiotics, quinidine, quinine and magnesium salts (see Precautions).
Paediatric patients: No formal interaction studies have been performed. The above mentioned interactions for adults and their special warnings and precautions for use (see Precautions) should also be taken into account for paediatric patients.
Incompatibilities: Physical incompatibility has been documented for rocuronium bromide when added to solutions containing the following active substances: amphotericin, amoxicillin, azathioprine, cefazolin, cloxacillin, dexamethasone, diazepam, enoximone, erythromycin, famotidine, furosemide, hydrocortisone sodium succinate, insulin, intralipid, methohexital, methylprednisolone, prednisolone sodium succinate, thiopental, trimethoprim and vancomycin.
This medicinal product must not be mixed with other medicinal products except those mentioned in section "Pharmaceutical precautions" under Cautions for Usage.