Interaction between Botulinum toxin type A and Netilmicin
Major
Synergy
| ID | DDInter225 and DDInter1283 |
| Interaction | The effects of botulinum toxin may be potentiated by neuromuscular blockers, aminoglycoside antibiotics, and other drugs that can interfere with neuromuscular transmission. Botulinum toxin inhibits the release of acetylcholine from peripheral cholinergic nerve endings, thus additive neuromuscular blocking effects may occur when these agents are used together. |
| Management | Caution is advised when botulinum toxin is used in combination with neuromuscular blockers, aminoglycoside antibiotics, or other drugs that can interfere with neuromuscular transmission. These drugs should be avoided in patients suspected of having botulinum toxin overdose or poisoning. Because the effects of botulinum toxin products may spread from the area of injection, patients should be monitored closely for adverse effects such as asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties, which can occur hours to weeks after injection. |
| References | |
| Alternative for Botulinum toxin type A |
M03A
|
| Alternative for Netilmicin |
S01A
Acyclovir
Trifluridine
Benzylpenicillin (sodium)
Sulfacetamide (ophthalmic)
Moxifloxacin
Chlorhexidine
More
|
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.